Need some clearification with the html form entry module

Following the instructions on the implementers guide, i created a form using the html form entry module. The form displays well in the design page but when i use it to fill patient information, after filling everything, the form display is different. So i don’t know whether that is the intended way it is suppose to display or there is something i am doing wrong. Link to image of the form after design http://picpaste.com/valid_form-KHC0OeiD.png, link to image after filling patient information http://picpaste.com/patient_information-7k2tHaLL.png.

Peeking at that image, I wonder if the

<br \/ >

are coming from the fact that you have spaces in your html tag somewhere that the parser is not expecting them.