Koha/koha-tmpl/intranet-tmpl/prog/en/modules/members/maninvoice.tmpl

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<!-- TMPL_INCLUDE NAME="doc-head-open.inc" -->
<title>Koha &rsaquo; Borrowers &rsaquo; Create Manual Invoice</title>
<!-- TMPL_INCLUDE NAME="doc-head-close.inc" -->
</head>
<body>
<!-- TMPL_INCLUDE NAME="header.inc" -->
<!-- TMPL_INCLUDE NAME="members-search.inc" -->
<div id="breadcrumbs"><a href="/cgi-bin/koha/mainpage.pl">Home</a> &rsaquo; <a href="/cgi-bin/koha/members/members-home.pl">Patrons</a> &rsaquo; Manual Invoice</div>
<div id="doc3" class="yui-t2">
<div id="bd">
<div id="yui-main">
<div class="yui-b">
<!-- TMPL_IF NAME="ERROR" -->
<!-- TMPL_IF NAME="ITEMNUMBER" -->
ERROR an invalid itemnumber was entered, please hit back and try again
<!-- /TMPL_IF -->
<!-- TMPL_ELSE -->
<form action="/cgi-bin/koha/members/maninvoice.pl" method="post"><input type="hidden" name="borrowernumber" value="<!-- TMPL_VAR Name="borrowernumber" -->" />
<table>
<caption>Manual Invoice</caption>
<tr><th scope="row">Borrowernumber</th><td><!-- TMPL_VAR Name="borrowernumber" --></td></tr>
<tr><th scope="row">Type</th><td><select name="type">
<option value="L">Lost Item</option>
<option value="F">Fine</option>
<option value="A">Account Management Fee</option>
<option value="N">New Card</option>
<option value="M">Sundry</option>
<option value="REF">Cash Refund</option>
</select></td></tr>
<tr><th scope="row">Itemnumber</th><td><input type="text" name="itemnum" /></td></tr>
<tr><th scope="row">Description</th><td><input type="text" name="desc" size="50" /></td></tr>
<tr><th scope="row">Amount</th><td>$<input type="text" name="amount" /></td></tr>
</table>
<input type="submit" name="add" value="Add Charge" />
</form>
<form action="/cgi-bin/koha/members/boraccount.pl" method="get"><input type="hidden" name="borrowernumber" value="<!-- TMPL_VAR Name="borrowernumber" -->" /><input type="submit" value="Cancel" /></form>
<!-- /TMPL_IF -->
</div>
</div>
<div class="yui-b">
<!-- TMPL_INCLUDE NAME="members-menu.inc" -->
</div>
</div>
<!-- TMPL_INCLUDE NAME="intranet-bottom.inc" -->