[% META title = 'Admin » Edit General Practitioner' -%]
<!-- BEGIN admin/config/generalpractitioners/edit.tt -->
[% # PROCESS dumper.tt dump = c.stash.errs %]
[% # PROCESS admin/system_nav.tt page = 'trials' %]
[% general_practitioners_dfv_js %]
[% PROCESS admin/referral_nav.tt page = 'practitioners' %]
<h2 align="center">Edit General Practitioner Details</h2>
[% IF dfv_errors %]
<dl>
<dt class="error">[% c.cfg('msg').dfv_errors %]</dt>
[% IF error_national_code %]
<dd>GP code [% error_national_code %]</dd>[% END %]
[% IF error_name %]
<dd>Name [% error_name %]</dd>[% END %]
[% IF error_practice_code %]
<dd>Practice code [% error_practice_code %]</dd>[% END %]
</dl>
[% END %]
<form method="post" action="[% app_url %]/config/general-practitioners/update/[% data.id %]"
[% general_practitioners_onsubmit %] name="general_practitioner" id="general_practitioner">
<table>
<tr>
<th [% IF error_national_code %]class="error"[% END %]>GP Code</th>
<th [% IF error_name %]class="error"[% END %]>Name</th>
<th>Practice Address</th>
<th [% IF error_practice_code %]class="error"[% END %]>Practice Code</th>
<th [% IF error_active %]class="error"[% END %]>Active</th>
</tr>
<tr>
<td><!-- can't edit this: -->
<p>[% data.national_code | html %]</p>
</td>
<td>
<input type="text" name="name" size="20" value="[% data.name %]" />
</td>
<td><!-- can't edit this: -->
<p>[% data.display_name | html %]</p>
</td>
<td><!-- can't edit this: -->
<p>[% data.organisation_code | html %]</p>
</td>
<td>
<select name="active">
[% FOREACH option IN ['yes', 'no'] %]
<option value="[% option %]" [% 'selected' IF option == data.active %]>
[% option %]
</option>
[% END %]
</select>
</td>
<td>
[% site.html.submit %]
</td>
</tr>
</table>
</form>
<p>[% site.html.back_button %]</p>
<!-- END admin/config/generalpractitioners/edit.tt -->