<!-- BEGIN [% template.name %] -->
  [% META title = 'Worklist &raquo; Plasma Storage Labels' -%]

    <h3>Print plasma storage labels</h3>

    <form action="[% app_url %]/local_labels/print_plasma_storage_labels"
		method="post" name="worksheet" id="worksheet">
    <table>
      <tr>
        <td class="borderless"></td>
        <th>Lab No</th>
        <th>Name</th>
        <th>Sample</th>
		<th># labels</th>
      </tr>

    [% i = 0;
	  FOREACH entry IN data; # INCLUDE dumper.tt dump = entry
		patient = entry.patient;
		request = entry.request;
	%]
	  <tr>
        <td>[% i = i + 1; i %]</td>
        <td>
          [% PROCESS site/lab_number.tt want_url = 0 data = entry.request %]
        </td>
        <td class="[% class %]">
          [% patient.last_name.upper %], [% patient.first_name.ucfirst %]
        </td>
        <td>[% entry.specimen %]</td>
        <td>
            <select name="label_id">
                <option value="">--</option>
                [% FOR n = [0 .. 20] %]
                  <option value="[% request.id %]~[% entry.specimen %]~[% n %]">
                    [% n %]</option>
                [% END %]
            </select>
        </td>
      </tr>
    [% END %]
    </table>
    <p>[% site.html.back_button %] [% site.html.submit %]</p>
<!-- END [% template.name %] -->
