[% META title = 'Rename HMRN » Treatment & Trial Options' -%]
<!-- BEGIN [% template.name %] -->
[% # PROCESS dumper.tt dump = c.param('id') %] <!-- Type ID -->
[% # PROCESS dumper.tt dump = c.param('Id') %] <!-- Detail ID -->
[% # PROCESS dumper.tt dump = edit_mode %] <!-- Detail ID -->
[% # PROCESS dumper.tt dump = opts %]
[% # PROCESS dumper.tt dump = treatment_ids %]
[%
type_id = treatment_ids.type_id;
detail_id = treatment_ids.detail_id;
%]
<h2 align="center">Rename HMRN treatments & clinical trial options</h2>
<p>Enter new description below:</p>
<form method="post" name="tr_rename" id="tr_rename"
action="[% app_url %]/hmrn/treatment_rename/[%type_id%]/[%detail_id%]">
<table class="indent">
<tr>
<td class="label">Type:</td>
<td class="content">
<input type="text" name="tr_type" id="tr_type" class=""
[% IF edit_mode == 'DETAIL' %]disabled[% END %]
value="[% opts.tx_lookup_types.$type_id %]" size="50" />
</td>
<!-- <td>[%type_id%]</td> -->
</tr>
[% IF edit_mode == 'DETAIL' %]
<tr>
<td class="label">Detail:</td>
<td class="content">
<input type="text" name="tr_detail" id="tr_detail" class=""
value="[% opts.tx_lookup_details.$detail_id %]" size="50" />
</td>
<!-- <td>[%detail_id%]</td> -->
</tr>
[% END %]
<tr class="borderless">
<td>[% site.html.back_button %]</td>
<td align="right">
[% site.html.submit %]
[% site.html.reset %]
</td>
</tr>
</table>
</form>
<!-- END [% template.name %] -->