[% META title = 'Patient &raquo; Delete Patient' -%]

    [% # PROCESS admin/user_nav.tt page = 'user_list' %]
	[% # PROCESS dumper.tt dump = c.param('id') %]

    <h3>Confirm you really want to delete this patient:</h3>

   <form method="post" action="[% app_url %]/patient/delete_patient/[% patient.id %]" />

    <p class="indent">
		[% patient.last_name | upper %],
		<span>[% patient.first_name | ucfirst %]</span>
        <span>[% patient.middle_name | ucfirst %]</span> ::
		[% patient.dob.strftime('%d.%b.%Y') %] ::
		[% patient.nhs_number || site.html.grey_null %]
        <input type="checkbox" name="confirm_delete" value="1">
		<input type='submit' value='Delete' name='.submit' class='button' />
    </p>

	<p>
		[% site.html.back_button %]
	</p>
    </form>