[% META title = 'Patient » Edit Unit Number' -%]
<h2 class="header">Edit patient unit number</h2>
[% # PROCESS dumper.tt dump = count %]
[% patient_case_dfv_js %]
[% IF dfv_errors %]
<p class="error">[% c.cfg('msg').dfv_errors %]</p>
[% IF error_patient_id %]
<ul><li>[% c.cfg('msg').require_one %]</li></ul>
[% END %]
[% END %]
<p>
<strong>Patient demographic data:</strong>
[ <a href="[% app_url %]/patient/register_edit_patient/[% case.patient.id %]">Edit</a> ]
</p>
<div class="indent" style="text-align: center">
<table>
<tr>
<th>Last Name</th>
<th>First Name(s)</th>
<th>Gender</th>
<th>D.o.B</th>
<th>NHS Number</th>
<th>Location</th>
</tr>
<tr>
<td>[% case.patient.last_name | upper %]</td>
<td>
<span>[% case.patient.first_name | ucfirst %]</span>
<span>[% case.patient.middle_name | ucfirst %]</span>
</td>
<td>[% case.patient.gender || 'U' %]</td>
<td>[% case.patient.dob.strftime('%d.%b.%Y') || site.html.grey_null %]</td>
<td>[% case.patient.nhs_number || site.html.grey_null %]</td>
<td>[% PROCESS site/display_name.tt location = case.referral_source.display_name %]</td>
</tr>
</table>
</div>
<form action="[% app_url %]/patient/update_case/[% case.id %]" method="post" name="edit_case"
id="edit_case" [% patient_case_onsubmit %]>
<p class="indent">Unit/case number:
<input type="text" name="unit_number" size="12" value="[% case.unit_number %]" />
[% IF c.user_can('delete_record') AND ! count %]
[ <a href="[% app_url %]/patient/delete_case/[% case.id %]">DELETE CASE</a> ]
[% END %]
</p>
[% IF count %]
<p class="bold">
Number of existing records affected by this change =
<span class="highlight">[% count %]</span>
</p>
[% END %]
<p class="center">
[% site.html.submit %]
[% site.html.reset %]
</p>
</form>