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It's not a patch. It's a replacement EXE file for the game. Open the RAR file, look at the file name in there (MAINAPP.EXE). Go to your game folder, grab that file (to back up so you can patch the game again later) and copy it to a seperate directory.
Then extract the MAINAPP.EXE file from the RAR file you see here to the Madden 2004 folder (usually C:\Program Files\EA SPORTS\Madden NFL 2004\) and you're all done.
It basically is a cracked EXE file to remove the CD checking of the normal game.
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