Create the actual admin page

I have the menu setup but I help with creating the admin page. I get includes errors with this…

<?php

    //must check that the user has the required capability
    if (!current_user_can('manage_options'))
    {
      wp_die( __('You do not have sufficient permissions to access this page.') );
    }

    // variables for the field and option names
    $opt_name = mysql_real_escape_string($_POST['name']);
    $hidden_field_name = 'mt_submit_hidden';
    $data_field_name = 'name';

    // See if the user has posted us some information
    // If they did, this hidden field will be set to 'Y'
    if( isset($_POST[ $hidden_field_name ]) && $_POST[ $hidden_field_name ] == 'Y' ) {
        // Read their posted value
        $opt_val = $_POST[ $data_field_name ];

        // Save the posted value in the database

        // Put an settings updated message on the screen

?>
	<div class="updated"><p><strong><?php _e('settings saved.', 'menu-test' ); ?></strong></p></div>
<?php

    }

    // Now display the settings editing screen

    echo '<div class="wrap">';

    // settings form

    ?>

    <form name="form1" method="post" action="">
    <input type="hidden" name="<?php echo $hidden_field_name; ?>" value="Y">

    <p>
    <input type="text" name="<?php echo $data_field_name; ?>" value="<?php echo $opt_val; ?>" size="50">
    </p><hr />

    <p class="submit">
    <input type="submit" name="Submit" class="button-primary" value="<?php esc_attr_e('Save Changes') ?>" />
    </p>

    </form>
    </div>

http://wordpress.org/extend/plugins/admin-menu-editor/