<!-- BEGIN [% component.name %] -->
<p class="section_header">Report</p>
[%
# INCLUDE dumper.tt dump = tt_regex;
# INCLUDE dumper.tt dump = vars.profile;
required_fields = session.validation_profile.required;
# moved 'push' logic to model:
# required_fields.push('biopsy_site')
# IF data.specimen.match(tt_regex.histology_type) OR data.report.biopsy_site;
# required_fields.push('gross_description')
# IF data.specimen.match(tt_regex.fixed_or_trephine) OR data.report.gross_description;
%]
[% BLOCK required_field %]<span class="big red hidden-print">*</span>[% END %]
[% BLOCK required %]required="1"[% END %]
<form action="[% app_url %]/report/[% data.id %]"
method="post" [% this_onsubmit # set above %] name="reportForm" id="reportForm">
<table class="indent" id="report">
<tr>
<td class="field-label align-top">Request notes:</td>
<td class="content">
<textarea name="request_notes" rows="1" cols="70"
class="expand20-200">[% data.report.request_notes %]</textarea>
</td>
</tr>
<tr>
<td class="field-label align-top">Request details:</td>
<td class="content">
<textarea name="clinical_details" rows="1" cols="70"
class="expand20-200">[% data.report.clinical_details %]</textarea>
</td>
</tr>
<tr>
[% is_required = required_fields.grep('status').size %]
<td class="field-label">
[% INCLUDE required_field IF is_required %]
Request status:
</td>
<td class="content">
[% FOREACH option IN [ 'new', 'relapse', 'default' ];
status_match = data.report.status.match(option) ? 1 : 0 %]
<span class="[% status_match ? 'title' : 'normal' %]">
[% option.replace('default','other') | ucfirst %]
</span>
<input type="radio" name="status" [% INCLUDE required IF is_required %]
value="[% option %]" [% 'checked' IF status_match %] />
<span style="margin-left: 0.5em"> </span>
[% END %]
[% error_status %]
</td>
</tr>
<!-- specimen details -->
<tr>
<td colspan="2">
<p class="section_header"><span class="info">Specimen details:</span></p>
</td>
</tr>
[% is_required = required_fields.grep('biopsy_site').size; IF is_required %]
<tr>
<td class="field-label align-top">
[% INCLUDE required_field IF is_required %]
Anatomical site:
</td>
<td class="content">
<input type="hidden" name="_require_biopsy_details" value="1" />
<textarea name="biopsy_site" rows="1" cols="70" class="expand20-200"
[% INCLUDE required %] id="biopsy_site">[% data.report.biopsy_site %]
</textarea>
[% error_biopsy_site %]
</td>
</tr>
[% END %]
[% is_required = required_fields.grep('gross_description').size; IF is_required %]
<tr>
<td class="field-label align-top">
[% INCLUDE required_field %]
Gross description:
</td>
<td class="content">
<input type="hidden" name="_require_gross_description" value="1" />
<textarea name="gross_description" rows="1" cols="70" [% INCLUDE required %]
class="expand20-200" id="gross_description">[% data.report.gross_description %]
</textarea>
[% error_gross_description %]
</td>
</tr>
[% END %]
<tr>
[% is_required = required_fields.grep('morphology').size %]
<td class="field-label align-top">
[% INCLUDE required_field IF is_required %]
Morphology:
</td>
<td class="content">
<textarea name="morphology" rows="1" cols="70" class="expand20-200"
[% INCLUDE required IF is_required %]
id="morphology">[% data.report.morphology %]</textarea>
[% error_morphology %]
</td>
</tr>
<tr>
[% is_required = required_fields.grep('specimen_quality').size %]
<td class="field-label">
[% INCLUDE required_field IF is_required %]
Specimen quality:
</td>
<td class="content">
[% FOREACH option IN ['good', 'adequate', 'poor'];
quality_match = data.report.specimen_quality.match(option) ? 1 : 0 %]
<span class="[% quality_match ? 'title' : 'normal' %]">
[% option | ucfirst %]
</span>
<input type="radio" [% INCLUDE required IF is_required %]
name="specimen_quality" value="[% option %]"
[% 'checked' IF quality_match %] />
<span style="margin-left: 0.5em" class="spacer"> </span>
[% END %]
[% error_specimen_quality %]
</td>
</tr>
<!-- diagnosis details -->
<tr>
<td colspan="2">
<p class="section_header"><span class="info">Diagnosis details:</span></p>
</td>
</tr>
<tr>
[% is_required = required_fields.grep('diagnosis_id').size %]
<td class="field-label">
[% INCLUDE required_field IF is_required %]
Primary diagnosis:
</td>
[% PROCESS autosuggest.tt
varname = 'diagnosis'
param_id = 'diagnosis_id'
param_name = 'diagnosis'
method_name = 'get_diagnoses'
%]
<td class="search_bar">
<div class="input-group">
<span class="input-group-addon hidden-print">
<i class="glyphicon glyphicon-search"></i>
</span>
<input style="width: 440px" type="text" id="diagnosis" name="_diagnosis"
class="form-control" [% INCLUDE required IF is_required %]
value="[% data.report.diagnosis %]" placeholder="type a few letters" />
<input type="hidden" id="diagnosis_id" name="diagnosis_id"
value="[% data.report.diagnosis_id %]" />
[% error_diagnosis_id %]
</div>
</td>
</tr>
<tr>
[% is_required = required_fields.grep('comment').size %]
<td class="field-label align-top">
[% INCLUDE required_field IF is_required %]
Comment:
</td>
<td class="content">
<textarea name="comment" rows="3" cols="70" class="expand20-500"
[% INCLUDE required IF is_required %]
id="comment">[% data.report.comment | html %]</textarea>
[% error_comment %]
</td>
</tr>
<tr>
<td class="field-label">Secondary diagnosis:</td>
<td class="search_bar">
[% PROCESS autosuggest.tt
varname = 'diagnosis'
param_id = 'secondary_diagnosis_id'
param_name = 'secondary_diagnosis'
method_name = 'get_diagnoses'
no_autosuggest_js = 1; # already loaded above
%]
<div class="input-group">
<span class="input-group-addon hidden-print">
<i class="glyphicon glyphicon-search"></i>
</span>
<input style="width: 440px" type="text" id="secondary_diagnosis"
name="_secondary_diagnosis" class="form-control"
value="[% data.report.secondary_diagnosis %]"
placeholder="type a few letters" />
<input type="hidden" id="secondary_diagnosis_id" name="secondary_diagnosis_id"
value="[% data.report.secondary_diagnosis_id %]" />
[% error_secondary_diagnosis_id %]
</div>
</td>
</tr>
[% IF data.report.created_at %]
<tr>
<td class="field-label">Reported:</td>
<td>[% data.report.created_at.strftime('%A %d.%b.%Y %T') %]</td>
</tr>
[% IF data.report.updated_at %]
<tr>
<td class="field-label">Last updated:</td>
<td>[% data.report.updated_at.strftime('%A %d.%b.%Y %T') %]</td>
</tr>
[% END; END %]
<tr>
<td colspan="2"><hr /></td>
</tr>
<tr class="hidden-print">
<td colspan="2" align="center">
<input class="btn btn-info" type="submit" value="Submit">
<input class="btn btn-danger" type="reset">
</td>
</tr>
</table>
<!-- END [% component.name %] -->