change service, billing, and payment info in selfservice
[freeside.git] / fs_selfservice / FS-SelfService / cgi / bill.html
1 <TR>
2   <TD ALIGN="right">P.O.&nbsp;number</TD>
3   <TD><INPUT TYPE="text" NAME="payinfo" SIZE=10 MAXLENGTH=20 VALUE="<%=$payinfo%>"></TD>
4 </TR><TR>
5   <TD ALIGN="right">Attention</TD>
6   <TD><INPUT TYPE="text" SIZE=32 MAXLENGTH=80 NAME="payname" VALUE="<%=$payname%>"></TD>
7 </TR>