<div class="details">
    <h3 class="text-header-m1">Request Details</h3>

    <ul data-role='listview' data-inset='true' data-theme='c'>
        <li><span class="fieldname">Clinic</span><span class="fieldvalue"><%- clinicName %></span></li>
        <li><span class="fieldname">Accession Number</span><span class="fieldvalue"><%- accessionno %></span></li>
        <li><span class="fieldname">Appointment Length</span><span class="fieldvalue"><%- appointmentLength %></span></li>
        <li><span class="fieldname">Patient Name</span><span class="fieldvalue"><%- patientName %></span></li>
        <li><span class="fieldname">SSN</span><span class="fieldvalue"><%- ssn %></span></li>
        <li><span class="fieldname">Fasting</span><span class="fieldvalue"><%- fastNonFasting %></span></li>
        <li><span class="fieldname">Recall Date</span><span class="fieldvalue"><%- recallDate %></span></li>
        <li><span class="fieldname">Recall Date 1</span><span class="fieldvalue"><%- recallDate1 %></span></li>
        <li><span class="fieldname">Comments</span><span class="fieldvalue"><%- comment %></span></li>
    </ul>
</div>