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-rw-r--r--fs_selfservice/FS-SelfService/cgi/bill.html7
1 files changed, 7 insertions, 0 deletions
diff --git a/fs_selfservice/FS-SelfService/cgi/bill.html b/fs_selfservice/FS-SelfService/cgi/bill.html
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index 000000000..bbdf1f210
--- /dev/null
+++ b/fs_selfservice/FS-SelfService/cgi/bill.html
@@ -0,0 +1,7 @@
+<TR>
+ <TD ALIGN="right">P.O.&nbsp;number</TD>
+ <TD><INPUT TYPE="text" NAME="payinfo" SIZE=10 MAXLENGTH=20 VALUE="<%=$payinfo%>"></TD>
+</TR><TR>
+ <TD ALIGN="right">Attention</TD>
+ <TD><INPUT TYPE="text" SIZE=32 MAXLENGTH=80 NAME="payname" VALUE="<%=$payname%>"></TD>
+</TR>