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<!-- BEGIN hmrn/data/myeloid.tt -->
    [% # PROCESS dumper.tt dump = hmrn_data.precursor %]
    
	<h4 class="indent">2. Myelodysplastic/myeloproliferative data:</h4>
	
    [% IF not_using_validationEngine_jquery # then use 'basic' jquery val %]
	<script type="text/javascript"> 
	    $(document).ready(function() { 
	      $("#myeloid").validate({ 
            rules: { },
          });
        });
  </script>
    [% ELSE %]
	<script type="text/javascript">
		$(document).ready(function() {
			$("#myeloid").validationEngine()
		})
	</script>
    [% END %]
  
  <form method="post" action="[% app_url %]/hmrn_data/edit/[% data.id
		%]/[% patient.id %]" name="myeloid" id="myeloid">
        <input type="hidden" name="data_set" value="myeloid" />
        
        [% IF error_mds_or_mpd %]
            <p class="error indent">require a full MPD or MDS data set (or both)</p>
        [% END %]
        
		<table class="indent">
			<tr>
				<td class="label">Splenomegaly:</td>
				<td class="content">
                    [% PROCESS build_select_field
                        name  = 'splenomegaly'
                        type  = 'myeloid'
                        class = 'validate[required]]'
                    %]
                    [% error_splenomegaly %]
				</td>
				<td class="label">Detected by:</td>
				<td class="content">
                    [% PROCESS build_select_field
                        name  = 'detection_spleen'
                        type  = 'myeloid'
                        class = 'validate[required]]'
                    %]
                    [% error_detection_spleen %]
				</td>
                <td class="grey borderless">[common]</td>
			</tr>
            
			<tr>
				<td class="label">Hepatomegaly:</td>
				<td class="content">
                    [% PROCESS build_select_field
                        name  = 'hepatomegaly'
                        type  = 'myeloid'
                        class = 'validate[required]]'
                    %]
                    [% error_hepatomegaly %]
				</td>
				<td class="label">Detected by:</td>
				<td class="content">
                    [% PROCESS build_select_field
                        name  = 'detection_liver'
                        type  = 'myeloid'
                        class = 'validate[required]]'
                    %]
                    [% error_detection_liver %]
				</td>
                <td class="grey borderless">[common]</td>
			</tr>
            
			<tr>
				<td class="label">Erythropoietin:</td>
				<td class="hmrnMPD">
                    [% PROCESS build_select_field
                        name  = 'epo'
                        type  = 'myeloid'
                        class = 'normal'
                    %]
                    [% error_epo %]
				</td>
				<td class="label">Red-cell mass:</td>
				<td class="hmrnMPD">
                    [% PROCESS build_select_field
                        name  = 'rcm'
                        type  = 'myeloid'
                        class = 'normal'
                    %]
                    [% error_rcm %]
				</td>
                <td class="grey borderless">[MPD data]</td>
			</tr>
            
			<tr>
				<td class="label">RBC dependent:</td>
				<td class="hmrnMDS">
                    [% PROCESS build_select_field
                        name  = 'transfusion'
                        type  = 'myeloid'
                        class = 'normal'
                    %]
                    [% error_transfusion %]
				</td>
				<td class="label">Cytopenias:</td>
				<td class="hmrnMDS">
                    [% PROCESS build_select_field
                        name  = 'cytopenias'
                        type  = 'myeloid'
                        class = 'normal'
                    %]
                    [% error_cytopenias %]
				</td>
                <td class="grey borderless">[MDS data]</td>
			</tr>
			<tr>
				<td class="label">Karyotype:</td>
				<td class="hmrnMDS">
                    [% PROCESS build_select_field
                        name  = 'karyotype'
                        type  = 'myeloid'
                        class = 'normal'
                    %]
                    [% error_karyotype %]
				</td>
				<td class="label">BM CD34:</td>
				<td class="hmrnMDS">
					<input type="text" name="cd34" id="cd34" size="2"
                        value="[% hmrn_data.params.myeloid.cd34 %]" />
                    [% error_cd34 || '[' _ '%' _ ']' %]
				</td>
                <td class="grey borderless">[MDS data]</td>
			</tr>
			[% INCLUDE hmrn_submit %]
		</table>
    </form>
<!-- END hmrn/data/myeloid.tt -->