<style>
	.send_proxy_label {
		padding: 3px !important;
	}
</style>
<span name="add_servers">
	<input name="prefix" class="prefix form-control" title="servers prefix" size="3" placeholder="web" style="display: none;">
	<input name="template-number" class="prefix form-control" title="servers num" value="3" type="number" style="width: 35px; display: none;">
	<input name="servers" required title="Backend IP" size=14 placeholder="xxx.xxx.xxx.xxx" class="form-control">:
	<input name="server_port" required title="Backend IP" size=3 placeholder="yyy" class="form-control">
	<span class="send_proxy"></span>
	<br />
	<input name="servers" title="Backend port" size=14 placeholder="xxx.xxx.xxx.xxx" class="form-control second-server"><span class="second-server">:</span>
	<input name="server_port" title="Backend port" size=3 placeholder="yyy" class="form-control second-server">
	<span class="send_proxy"></span>
	<br />
	<input name="servers" title="Backend port" size=14 placeholder="xxx.xxx.xxx.xxx" class="form-control second-server"><span class="second-server">:</span>
	<input name="server_port" title="Backend port" size=3 placeholder="yyy" class="form-control second-server">
	<span class="send_proxy"></span>
</span>
<span>
	<a class="add-server" name="add-server-input" title="Add backend server" style="cursor: pointer;"></a>
</span>
<a href="https://cbonte.github.io/haproxy-dconv/1.8/configuration.html#4.2-server-template" title="Read about Server-template" target="_blank" class="prefix" style="display: none; font-size: 13px; color: #23527c;">Read about Server-template</a>