<!-- BEGIN search/referral_source_search.tt -->
<form method="get" action="[% app_url %]/config/referral-sources/search"
name="find_referral_source" id="find_referral_source">
<table>
<tr>
<td class="label">Location name:</td>
<td>
<input type="text" name="display_name" value="[% c.query.param('display_name') %]" />
[% IF error_display_name %]
[% error_display_name %]
[% ELSE %]
'%' for all
[% END %]
</td>
</tr>
<tr>
<td class="label">Organisation Code:</td>
<td>
<input type="text" name="organisation_code" value="[% c.query.param('organisation_code') %]" />
[% error_organisation_code %]
</td>
</tr>
<tr>
<td class="label">Location type:</td>
<td>
<select name="referral_type_id">
<option value="">--select one--</option>
<option value="4">hospital</option>
<option value="5">practice</option>
</select>
[% error_location_type_id %]
</td>
</tr>
<tr>
<td class="borderless" colspan="2" align="center">[% site.html.submit %]</td>
</tr>
</table>
</form>
<!-- END search/referral_source_search.tt -->