<table width="500" border="0" cellspacing="0" cellpadding="2">
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<tr>
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<td class="frmText11">{tmpl_var name='server_id_txt'}:</td>
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<td class="frmText11">
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<select name="server_id" class="text">
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{tmpl_var name='server_id'}
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</select>
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</td>
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</tr>
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<tr>
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<td class="frmText11">{tmpl_var name='ip_address_txt'}:</td>
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<td class="frmText11"><input name="ip_address" type="text" class="text" value="{tmpl_var name='ip_address'}" size="15" maxlength="15"></td>
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</tr>
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<tr>
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<td width="126" class="frmText11">{tmpl_var name='virtualhost_txt'}:</td>
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<td width="366" class="frmText11">{tmpl_var name='virtualhost'}</td>
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</tr>
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<tr>
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<td class="frmText11"> </td>
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<td class="frmText11"> </td>
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</tr>
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<tr>
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<td> </td>
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<td><input name="btn_save" type="button" class="button" value="{tmpl_var name='btn_save_txt'}" onClick="submitForm('pageForm','admin/server_ip_edit.php');"><div class="buttonEnding"></div>
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<input name="btn_cancel" type="button" class="button" value="{tmpl_var name='btn_cancel_txt'}" onClick="loadContent('admin/server_ip_list.php');"><div class="buttonEnding"></div>
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</td>
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</tr>
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</table>
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<input type="hidden" name="id" value="{tmpl_var name='id'}">
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