<input type="hidden" name="shiptocontact" value="[% HTML.escape(shiptocontact) %]">
<input type="hidden" name="shiptocp_gender" value="[% HTML.escape(shiptocp_gender) %]">
<input type="hidden" name="shiptocountry" value="[% HTML.escape(shiptocountry) %]">
+ <input type="hidden" name="shiptogln" value="[% HTML.escape(shiptogln) %]">
<input type="hidden" name="shiptodepartment_1" value="[% HTML.escape(shiptodepartment_1) %]">
<input type="hidden" name="shiptodepartment_2" value="[% HTML.escape(shiptodepartment_2) %]">
<input type="hidden" name="shiptoemail" value="[% HTML.escape(shiptoemail) %]">
<input type="hidden" name="type" value="[% HTML.escape(type) %]">
<input type="hidden" name="vc" value="[% HTML.escape(vc) %]">
<input type="hidden" name="lastmtime" value="[% HTML.escape(lastmtime) %]">
+[%- FOREACH row = HIDDENS %]
+ [% L.hidden_tag(row.name, row.value) %]
+[%- END %]
<p>
<table width="100%">