[% META title = 'Haematological Malignancy Research Network » Edit Post Code at Diagnosis' %]

<!-- BEGIN [% template.name %]  -->
    [% # PROCESS dumper.tt dump = dfv_err %]
    
    [%
        INCLUDE site/js/validationEngine.tt;
        addcss = [ 'validationEngine.jquery.css' ];

    %]
    <script type="text/javascript">
		$(document).ready(function() {
			$("#postCode").validationEngine()
		})
	</script>

    <form method="post" action="[% app_url %]/hmrn_data/edit_post_code/[% 
           c.param('id') %]/[% c.param('Id') %]" name="postCode" id="postCode">
        <p class="indent bold">Edit post-code at diagnosis:
    		<input type="text" name="post_code" size="12" class="validate[ajax[ajaxPostCode]]"
				id="post_code" value="[% post_code %]" />
        [% dfv_err.error_post_code %]
        [% site.html.submit %]
        [% site.html.reset %]
        </p>
    </form>
	
	<p class="indent">[% site.html.back_button %]</p>
<!-- END [% template.name %] -->