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<!-- BEGIN [% component.name %] -->
    [% # PROCESS dumper.tt dump = data %]
    
    [% BLOCK row;
        data = entry.request; # for lab_number.tt
		patient = data.patient_case.patient;
		location = data.patient_case.referral_source.display_name
    %]
	  <tr>
        <td>[% loop.count %]</td>
        <td>
          [% PROCESS site/lab_number.tt want_url = 1 %]
        </td>
        [% class = request_options_map.item(data.id).urgent ? 'red' : 'normal' %]
        <td class="[% class %]">
          [% patient.last_name   | upper %],
          [% patient.first_name  | ucfirst %]
          [% patient.middle_name | ucfirst %]
        </td>
		<td>[% data.created_at.strftime('%d.%m.%Y') %]</td>
        <td>[% specimen_map.item(data.id).sample_code.join(', ') %]</td>
		<td>[% PROCESS site/display_name.tt %]</td>
        <td>
          [% IF data.request_initial_screen %]
            [% data.request_initial_screen.screen.description | html %]
          [% ELSE %]
            [% site.html.grey_null %]
          [% END %]
		</td>
        [% class = request_options_map.item(data.id).doi ? 'red' : 'normal' %]
        <td class="[% class %]">[% entry.lab_test.field_label %]
		  [% '[P]' IF entry.lab_test.test_type.match('panel') %]		  
        </td>
        <td align="center">
            <input type="checkbox" name="request_id" value="[% data.id %]" />
        </td>
      </tr>
    [% END %]

    <p class="classname">[% site.html.back_button %]</p>
  
    <h3>Print [% extraction_type %] extraction worksheets</h3>
    
    <form action="[% app_url %]/local_worklist/xna_extraction_worksheet"
		method="post" name="worksheet" id="worksheet">
	  <input type="hidden" name="extraction_type" value="[% extraction_type %]" />
    <table>
      <tr>
        <td class="borderless"></td>		
        <th>Lab No</th>
        <th>Name</th>
        <th>Date</th>
        <th>Sample</th>
        <th>Source</th>
		<th>Presentation</th>
		<th>Investigation</th>
		<th>Print</th>
      </tr>
      
      [% FOREACH entry IN requests; PROCESS row; END %]
    </table>
    <p class="indent">
    <!--
      <input type="button" name="CheckAll" value="Select all"
        onClick="checkAll(document.fish_worksheets.request_id)">
    -->
      <input type="button" name="UnCheckAll" value="Clear all"
        onClick="uncheckAll(document.worksheet.request_id)">
        [% site.html.submit %]
    </p>
    </form>

<!-- END [% component.name %] -->