--- /dev/null
+<center>
+ <form action="{actionurl}" method="POST">
+ <input type=hidden name=elder_id value={elder_id}>
+
+ <table border="0" width="{table_width}" cellspacing="2" cellpadding="2">
+ <tr>
+ <td align="center" bgcolor="#c9c9c9"><font face="{font}"><b>{title}</b></font></td>
+ </tr>
+ </table>
+
+<!-- BEGIN assignment_list -->
+ <br><br>
+ <table border="0" width="{table_width}" cellspacing="2" cellpadding="2">
+ <tr>
+ <td align="center" bgcolor="#c9c9c9" colspan=20>
+ <font face="{font}"><b>Elder: {elder_name}</b></font>
+ </td>
+ </tr>
+ <tr bgcolor="#c9c9c9"><font face="{font}">{header_row}</tr>
+ {table_data}
+ </table>
+<!-- END assignment_list -->
+
+<!-- BEGIN save -->
+ <table width="70%" border="0" cellspacing="2" cellpadding="2" align=center>
+ <tr valign="bottom">
+ <td height="50" align="right">
+ <font face="{font}"><input type="submit" name="save" value="{lang_save}"></font></td>
+ <td height="50" align="center">
+ <font face="{font}"><input type="reset" name="reset" value="{lang_reset}"></font></form></td>
+ <td height="50" align="left">
+ <form action="{done_action}" method="POST">
+ <font face="{font}"><input type="submit" name="done" value="{lang_done}"></font></form></td>
+ </tr>
+ </table>
+</center>
+<!-- END save -->
+
+</center>