[% content_only = 1 %]
<html>
<head>
<title>Sample Linkage Form</title>
<style>
/* defined height for HTML::Barcode::Code128/39 */
table.hbc td.hbc_on,
table.hbc td.hbc_off { width: 2px; height: 20px; }
</style>
</head>
<body>
<div style="width: 100%">
<div class="inline">
<div class="header">100, 000 Genomes Project</div>
<div class="header">Sample Linkage Form</div>
</div>
<div class="inline logo">
<img src="http://localhost/images/YH-GMC.jpg" />
</div>
</div>
<p class="spacer"></p>
<div class="participant">
<p class="spacer"></p>
<table class="content">
<tr>
<th>
[% data.first_name.ucfirst %] [% data.last_name.upper %]
:: [% data.dob %] :: [% data.gender %]
</th>
</tr>
<tr>
<td>
<span class="header">NHS number:</span>
[% data.nhs_number %]
<div class="participant-barcode">
[% render_barcode(data.nhs_number) %]
</div>
</td>
</tr>
<tr>
<td>
<span class="header">Participant ID:</span>
[% data.participant_id %]
<div class="participant-barcode">
[% render_barcode(data.participant_id) %]
</div>
</td>
</tr>
<tr>
<td>
<span class="header">Family ID:</span>
[% data.family_id %]
<div class="participant-barcode">
[% render_barcode(data.family_id) %]
</div>
</td>
</tr>
<tr>
<td>
<span class="header">Referrer:</span>
[% data.referrer %], [% data.location %]
</td>
</tr>
<tr>
<td>
<span class="header">Disease type:</span>
[% data.disease_type %]
</td>
</tr>
<tr class="spacer"><td></td></tr>
</table>
<table class="content">
<tr>
<td>Date Samples Collected:</td>
<td class="label">dd / mm / YYYY</td>
</tr>
<tr>
<td>Time Samples Collected:</td>
<td class="label">hh : mm</td>
</tr>
<tr class="spacer"><td></td></tr>
<tr>
<td>Additional Samples in Group:</td>
<td class="label"><Additional Samples></td>
</tr>
</table>
</div>
<div class="sample">
<table class="content">
<tr>
<td colspan="2" id="info">
Peel off the labels below and stick on relevant tubes
</td>
</tr>
<tr>
<td class="edta">
<div><span class="header">4ml EDTA (#1) - DNA Blood Germline<span></div>
</td>
<td class="sticker">
[% text = data.participant_id _ '.1'; render_barcode(text) %]
<div class="barcode-text">[% text %]</div>
</td>
</tr>
<tr class="spacer"><td colspan="2"></td></tr>
<tr>
<td class="edta">
<div><span class="header">4ml EDTA (#2) - DNA Blood Germline</span></div>
</td>
<td class="sticker">
[% text = data.participant_id _ '.2'; render_barcode(text) %]
<div class="barcode-text">[% text %]</div>
</td>
</tr>
<tr class="spacer"><td colspan="2"></td></tr>
<tr>
<td class="serum">
<div><span class="header">8.5ml SST - Serum</span></div>
</td>
<td class="sticker">
[% text = data.participant_id _ '.3'; render_barcode(text) %]
<div class="barcode-text">[% text %]</div>
</td>
</tr>
<tr class="spacer"><td colspan="2"></td></tr>
<tr>
<td class="plasma">
<div><span class="header">8ml PST - LiHep Plasma</span></div>
</td>
<td class="sticker">
[% text = data.participant_id _ '.4'; render_barcode(text) %]
<div class="barcode-text">[% text %]</div>
</td>
</tr>
<tr class="spacer"><td colspan="2"></td></tr>
<tr>
<td>
<div><span class="header">2.5ml PAXgene RNA - RNA Blood</span></div>
</td>
<td class="sticker">
[% text = data.participant_id _ '.5'; render_barcode(text) %]
<div class="barcode-text">[% text %]</div>
</td>
</tr>
<tr class="spacer"><td colspan="2"></td></tr>
<tr>
<td align="center">
<div><span class="header">[NOT IN USE]</span></div>
</td>
<td class="sticker">
</td>
</tr>
</table>
</div>
</body>
</html>