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<!-- BEGIN hmrn/data/patient_summary.tt  -->

	[% PROCESS site/autosuggest.tt # needs to go before jquery-ui js or get error %]
    <script type="text/javascript" src="/js/jquery-ui-1.8.4.custom.min.js"></script>

    <script type="text/javascript">
	<!--
		function make_blank() {
			document.demographics.practice_name.value = "";
		}
	-->
	</script>

	<table>
		<tr class="borderless">
			<td>
				[% site.html.back_button %]
			</td>
			<td align="center">
				Diagnosis: <span id="hmrn_diagnosis">
					[% report_data.diagnosis.name || 'Unreported request' %]
					[[% report_data.diagnosis.icdo3 || 'non-ICDO3' %]]
				</span>
			</td>
			<td align="center">
				<a href="[% app_url %]/hmrn/history/[% data.id %]">History</a>
			</td>
		</tr>
	</table>

    <h3 class="header">Patient summary:</h3>
	
    <table class="indent">
      <tr>
        <th>Name</th>
        <th>DoB</th>
        <th>
			[% IF patient.nhs_number %]
				NHS number
			[% ELSE %]
				Unit number
          [% END %]
        </th>
        <th>Lab No.</th>
        <th>Reported</th>
        <th>Source</th>
        <th>Referrer</th>
      </tr>
	  
      <tr>
        <td>
          [% patient.last_name   | upper %],
          [% patient.first_name  | ucfirst %]
          [% patient.middle_name | ucfirst %]
		  [[% patient.gender %]]
        </td>
        <td>
          [% patient.dob.strftime('%d.%b.%Y') || site.html.grey_null %]
        </td>
        <td>
			[%
				IF patient.nhs_number;
					PROCESS site/nhs_number.tt nhs_number = patient.nhs_number;
				ELSE; data.patient_case.unit_number || site.html.grey_null;
				END;
			%]
        </td>
        <td>
          [% PROCESS site/lab_number.tt want_url = 1 # expects request object 'data' %]
        </td>
        <td>[% request_history.reported.time.strftime('%d.%b.%Y') %]</td>              
        <td>
          [% location = data.patient_case.referral_source.display_name %]
          [% PROCESS site/display_name.tt %]
        </td>
		<td>
			[% data.referrer_department.referrer.name %]
		</td>
	  </tr>
	</table>
	
    <h3 class="header">Demographic data:</h3>
	
    <form method="get" action="[% app_url %]/hmrn_data/edit_demographics" name="demographics"
		  id="demographics">
    <table class="indent">
		<tr>
			<td class="label">Address at diagnosis:</td>
			<td class="content">
				<textarea name="address" rows="2" cols="20">[% demographic_data.address %]</textarea>
			</td>
		</tr>
		<tr>
			<td class="label">Post code:</td>
			<td class="content">
				<input type="text" name="post_code" size="12"
					value="[% demographic_data.post_code %]" />
			</td>
		</tr>
		<tr>
			<td class="label">GP practice:</td>			
			<td class="content">
				[% IF hmrn_data.is_in_outreach # can't edit GP details if so %]
					<input type="text" style="width: 600px" [% site.html.readonly %]
						value="[% demographic_data.practice.display_name %]" />
					<span class="acronym"
						title="patient in outreach program; cannot edit GP practice details here">
						<strong>?</strong>
					</span>
				[% ELSE %]
					<input type="text" name="practice_name" id="location_name"
						value="[% demographic_data.practice.display_name %]"
						style="width: 600px" onclick="make_blank();" />
					<input type="hidden" id="source_id" name="practice_id" />
				</div>
				[% END %]
			</td>
		</tr>
		<tr>
			<td class="label">Status:</td>			
			<td class="content">
				<select name="status">
					[% FOREACH entry IN ['alive' 'dead'] %]
					<option value="[% entry %]"
						[% 'selected' IF entry == demographic_data.status %]>
						[% entry %]
					</option>
					[% END %]
				</select>
			</td>
		</tr>
		[% INCLUDE hmrn_submit %]
	</table>
	</form>
<!-- END hmrn/data/patient_summary.tt  -->