[% META title = 'Patient » Edit Unit Number' -%]
<h2 class="header">Edit patient unit number</h2>
[% # PROCESS dumper.tt dump = data.as_tree %]
[% # PROCESS dumper.tt dump = requests_count %]
[% # PROCESS dumper.tt dump = patient_case_count %]
[% patient_case_dfv_js %]
[% IF dfv_errors %]
<p class="error">[% c.cfg('msg').dfv_errors %]</p>
[% IF error_patient_id %]
<ul><li>[% c.cfg('msg').require_one %]</li></ul>
[% END %]
[% END %]
<p>
<strong>Patient demographic data:</strong>
[ <a href="[% app_url %]/patient/register_edit_patient/[% data.patient.id %]">Edit</a> ]
</p>
<div class="indent" style="text-align: center">
<table>
<tr>
<th>Last Name</th>
<th>First Name(s)</th>
<th>Gender</th>
<th>D.o.B</th>
<th>NHS Number</th>
<th>Location</th>
</tr>
<tr>
<td>[% data.patient.last_name | upper %]</td>
<td>
<span>[% data.patient.first_name | ucfirst %]</span>
<span>[% data.patient.middle_name | ucfirst %]</span>
</td>
<td>[% data.patient.gender || 'U' %]</td>
<td>[% data.patient.dob.strftime('%d.%b.%Y') || site.html.grey_null %]</td>
<td>[% data.patient.nhs_number || site.html.grey_null %]</td>
<td>[% PROCESS site/display_name.tt location = data.referral_source.display_name %]</td>
</tr>
</table>
</div>
<p class="spacer"></p>
[% PROCESS site/autosuggest.tt %]
<form action="[% app_url %]/patient/update_case/[% data.id %]" method="post" name="edit_case"
id="edit_case" [% patient_case_onsubmit %]>
<table class="indent">
<tr>
<td class="label">Unit/case number:</td>
<td class="content">
<input class="field" type="text" name="unit_number" size="12"
[% site.html.on_focus %] value="[% data.unit_number %]" />
[% error_unit_number %]
</td>
</tr>
<tr>
<td class="label">Location:</td>
<td class="search_bar">
<input style="width: 300px" type="text" id="location_name"
name="_location_name" value="[% data.referral_source.display_name %]" />
<input type="hidden" id="source_id" name="referral_source_id" />
[% IF error_referral_source_id %]
[% error_referral_source_id %]
[% ELSE %]
[ <a href="[% app_url %]/config/referral-sources">new</a> ]
[% END %]
</td>
</tr>
</tr>
</table>
[% IF requests_count %]
<p class="bold">
Number of existing records affected by this change =
<span class="highlight">[% requests_count %]</span>
</p>
[% END %]
<p class="center">
[% IF c.user_can('delete_record')
AND patient_case_count > 1 # can't delete patient case if it's the only 1
AND ! requests_count %]
[ <a href="[% app_url %]/patient/delete_case/[% data.id %]">DELETE CASE</a> ]
[% END %]
[% site.html.submit %]
[% site.html.reset %]
</p>
</form>