<!-- BEGIN request/edit/single_record_data.tt -->   
	<table class="indent">
        <tr>
            <td class="label">Unit number:</td>
            <td class="content">
				<input type="text" name="unit_number" value="[% this_case.unit_number %]" />
				[% error_unit_number %]
			</td>
        </tr>
        <tr>
            <td class="label">Location:</td>
			<td class="search_bar">
				<input style="width: 300px" type="text" id="location_name"
                    name="_location_name" value="[% this_case.referral_source.display_name %]" />
				<input type="hidden" id="source_id" name="referral_source_id" />
                [% IF error_referral_source_id %]
                    [% error_referral_source_id %]
                [% ELSE %]
                    [ <a href="[% app_url %]/config/referral-sources">new</a> ]
                [% END %]
			</td>
        </tr>
	</table>	
<!-- END request/edit/single_record_data.tt -->   

