[% META title = 'Patient » Delete Patient Case' -%]
[% # PROCESS admin/user_nav.tt page = 'user_list' %]
[% # PROCESS dumper.tt dump = c.param('id') %]
<h3>Confirm you really want to delete this case:</h3>
<form method="post" action="[% app_url %]/patient/delete_case/[% case.id %]" />
<p class="indent">
[% case.referral_source.display_name %] [ [% case.unit_number %] ]
<input type="checkbox" name="confirm_delete" value="1">
<input type='submit' value='Delete' name='.submit' class='button' />
</p>
<p>
[% site.html.back_button %]
</p>
</form>