</li>
<li class="price_paid">
<label class="price_paid">Price paid:</label>
<input name="price_paid" id="price_paid" type="text" value="[% request.price_paid %]">
<input name="price_paid" id="price_paid" type="text" value="[% request.price_paid | html %]">
<li class="req_id">
<label class="req_id">Request number:</label>
-