[% META title = 'Registration » Search for Patient Details' -%] [% # PROCESS dumper.tt dump = c.stash.errs %]

Search For Patient Details

[% # PROCESS site/form_validator.tt profile = 'patient_data' # can't do dates in future %] [% IF dfv_errors %]

[% c.cfg('msg').dfv_errors %]

[% END %] [% patient_search_data_dfv_js # doesn't work with 'require_some' %] [% INCLUDE site/snippets/help.tt file = 'patientsearch' %]

FORMAT: last name, followed by (optional) first name or first initial, comma-separated

Name: [% IF error_name; class = 'input_error'; ELSE; class = 'field'; END %] [% error_name %]

[% BLOCK validate_date; IF c.cfg('use_cgi_ajax') %] onChange="do_ajax( ['is_valid_date_day','is_valid_date_month','is_valid_date_year'], ['bad_date'] ); return true;" [% END; END %]
[% SET class = error_year || error_day ? 'input_error' : 'field' %]

FORMAT: dd / mm / yyyy

[% IF error_year || error_day %] invalid » [% END %] D.o.B:

Unit/NHS No: [% IF error_patient_id; class = 'input_error'; ELSE; class = 'field'; END %]

[% site.html.submit %] [% site.html.reset %]