<patTemplate:tmpl name="pageoutput" >
<form action="index2.php?option=com_jomres" method="post" name="adminForm">
{JOMRESTOOLBAR}
<table>
	<tr>
		<td class="jomres_title">{PAGETITLE}</td>
	</tr>
	<tr>
		<td>{JOMRESTOOLBAR}</td>
	</tr>
	<tr>
		<td>
			<table class="jradmin_table">
				<tr>
					<td class="jradmin_subheader_ca">{HEXNAME}</td>
					<td class="jradmin_subheader_ca">{HEXDESC}</td>
					<td class="jradmin_subheader_ca">{HEXPRICE}</td>
					<td class="jradmin_subheader_ca">{HEXCHARGEABLEDAILY}</td>
				</tr>
				<tr>
					<td class="jradmin_field_ca"><input class="inputbox" type="text" name="name" value="{EXNAME}" /></td>
					<td class="jradmin_field_ca"><input class="inputbox" type="text" name="desc" value="{EXDESCRIPTION}" /></td>
					<td class="jradmin_field_ca">{CURRENCY}<input class="inputbox" type="text" name="price" value="{EXPRICE}" size="7" /></td>
					<td class="jradmin_field_ca">{EXCHARGEABLEDAILY}</td>
				</tr>
			</table>
		</td>
	</tr>
</table>

<input type="hidden" name="step" value="2" />
<input type="hidden" name="option" value="com_jomres" />
<input type="hidden" name="task" value="add_adhoc_item_to_bill" />
</form>
</patTemplate:tmpl>