I need to create list and have a pick list associated with each item on the list

I need to create list and have a pick list associated with each item on the list

I need to create this type of field set up in leads and deals. The item list can be fixed but a user must be able to enter the quantity for each item.


Item Type                                                                                          Quantity
Item 1
1
Item 2
3
Item 3
2
Item 4
0
Item 5
0