<!-- BEGIN [% template.name %] -->
  [% META title = 'Pre-screen &raquo; Delete Pre-screen Data' -%]

  [% # PROCESS dumper.tt dump = data.as_tree %]
  
  <h3 class="header">Delete pre-screen data</h3>

    <p class="indent warning">Confirm you really want to delete this entry:</p>

	<form action="[% app_url %]/local_worklist_preregistration/delete/[% data.id %]"
		method="post">

    <input type="hidden" name="lab_section_id" value="[% lab_section_id %]" />

    <table class="indent">
      <tr>
        <th>LabNo</th>
        <th>Surname</th>
        <th>Screened</th>
        <td class="borderless"></td>
      </tr>

      <tr>
        <td>[% data.labno %]</td>
        <td>
          <input type="text" name="surname" size="15" [% site.html.disabled %]
            value="[% data.surname %]" />
        </td>
        <td>
          <select name="screened" [% site.html.disabled %]>
            [% FOREACH option IN ['yes','no'] %]
            <option value="[% option %]"
                [% 'selected' IF data.is_screened == option %]>
              [% option %]
            </option>
            [% END %]
          </select>
        </td>
        <td>
            <input type="checkbox" name="confirm_delete" value="1">
            <input type='submit' value='Delete' name='.submit' class='button' />
			<span class="error">THERE IS NO 'UNDO' OPTION</span>
        </td>
      </tr>
    </table>
  </form>
<!-- END [% template.name %] -->
