[% META title = 'Patient » Delete Patient' -%]
[% # PROCESS admin/user_nav.tt page = 'user_list' %]
[% # PROCESS dumper.tt dump = c.param('id') %]
<h3>Confirm you really want to delete this patient:</h3>
<form method="post" action="[% app_url %]/patient/delete_patient/[% patient.id %]" />
<p class="indent">
[% patient.last_name | upper %],
<span>[% patient.first_name | ucfirst %]</span>
<span>[% patient.middle_name | ucfirst %]</span> ::
[% patient.dob.strftime('%d.%b.%Y') %] ::
[% patient.nhs_number || site.html.grey_null %]
<input type="checkbox" name="confirm_delete" value="1">
<input type='submit' value='Delete' name='.submit' class='button' />
</p>
<p>
[% site.html.back_button %]
</p>
</form>