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<!-- BEGIN request/edit/display_request_data.tt -->
	<table class="indent">
        <tr>
            <td class="label">Referrer:</td>
			<td class="content">
				<input type="text" value="[% data.referrer_department.referrer.name %]"
					[% site.html.disabled %] />
            </td>
        </tr>
        <tr>
            <td class="label">Specimen:</td>
            <td class="content">
				<input type="text" value="[% request_data.specimen_map.item(data.id).sample_code.join(', ') %]"
					[% site.html.disabled %] />
			</td>
        </tr>
		
		[%
			IF request_data.has_optional.clinical_trial;
				trial_name = data.request_trial.trial.trial_name;
				trial_number = get_trial_number(patient.id, data.request_trial.trial_id);
			END;
		%]
        <tr>
            <td class="label">Trial/study:</td>
            <td class="content">
				<input type="text" value="[% trial_name %]"	[% site.html.disabled %] />
			</td>
        </tr>
        <tr>
            <td class="label">Trial no:</td>
            <td class="content">
				<input class="field" type="text" [% site.html.disabled %]
					value="[% trial_number %]" />
			</td>
		</tr>
		
		[%
			IF request_data.has_optional.external_ref;
				external_ref = data.request_external_ref.external_reference;
			END;
		%]
        <tr>
            <td class="label">External ref:</td>
            <td class="content">
				<input class="field" type="text" [% site.html.disabled %]
					value="[% external_ref %]" />
			</td>
        </tr>
	</table>
<!-- END request/edit/display_request_data.tt -->