[% META title = 'Patient » Merge Patients' -%]
<!-- BEGIN admin/patient/merge/default.tt -->
[% # PROCESS admin/user_nav.tt page = 'user_list' %]
[% # PROCESS dumper.tt dump = records %]
[% # PROCESS dumper.tt dump = report_map %]
[% # PROCESS dumper.tt dump = patients %]
<h2 class="header">Merge Patient Records</h2>
[% IF dfv_errors %]
<p class="error">[% c.config('msg').dfv_errors %]
require at least one entry from last name, unit number or dob</p>
[% END %]
[% INCLUDE site/snippets/help.tt file = 'patientmerge' %]
<form method="post" action="[% app_url %]/admin/patient_merge/search"
name="select" id="select">
<table class="indent">
<tr>
<td class="label"> Last Name:</td>
<td class="content">
<input type="text" name="last_name" tabindex="1"
value="[% c.query.param('last_name') %]" />
[% error_last_name %]
</td>
<td rowspan="4" class="borderless">
<input type="submit" name=".submit" value="Find" />
<a href="[% app_url %]/admin/patient_merge">RESET</a>
</td>
</tr>
<tr>
<td class="label">First Name:</td>
<td class="content">
<input type="text" name="first_name" tabindex="2"
value="[% c.query.param('first_name') %]" />
[% error_first_name %]
</td>
</tr>
<tr>
<td class="label">Unit number:</td>
<td class="content">
<input type="text" name="unit_number" tabindex="3"
value="[% c.query.param('unit_number') %]" />
[% error_unit_number %]
</td>
</tr>
[% BLOCK validate_date; IF c.cfg('use_cgi_ajax') %]
onChange="do_ajax(
['is_valid_date_day','is_valid_date_month','is_valid_date_year'],
['bad_date']
); return true;"
[% END; END %]
<tr>
[% SET class = error_year || error_day ? 'input_error' : 'field' %]
<td class="label">DoB:</td>
<td class="content">
<input type="text" name="dob_day" size="2" id="is_valid_date_day"
[% PROCESS validate_date %] maxlength="2" class="[% class %]"
value="[% c.query.param('dob_day') %]" [% site.html.on_focus %]
tabindex="4" />
<input type="text" name="dob_month" size="2" id="is_valid_date_month"
[% PROCESS validate_date %] maxlength="2" class="[% class %]"
value="[% c.query.param('dob_month') %]" [% site.html.on_focus %]
tabindex="5" />
<input type="text" name="dob_year" size="4" id="is_valid_date_year"
[% PROCESS validate_date %] maxlength="4" class="[% class %]"
value="[% c.query.param('dob_year') %]" [% site.html.on_focus %]
tabindex="6" />
[% UNLESS error_day || error_year # set if date invalid %]
<span class="ajax_error"><em id="bad_date">dd-mm-yyyy</em></span>
[% END %]
[% error_day || error_year # set if date invalid %]
</td>
</tr>
</table>
</form>
[% IF records.size || orphans.size; INCLUDE admin/patient/merge/list.tt; END %]
[% INCLUDE site/field_focus.tt form_name = 'select' field_name = 'last_name' %]
<!-- END admin/patient/merge/default.tt -->