<!-- BEGIN [% component.name %]  -->
  [%
    lab_data = outreach.immunology; # PROCESS dumper.tt dump = lab_data;
    fields = lab_data.keys; # PROCESS dumper.tt dump = fields;
  %]
  
  [% outreach_immunology_dfv_js %]
  
  <form method="post" action="[% app_url %]/outreach/lab_results/[% request_data.id %]"
      name="outreachImmunology" id="outreachImmunology" [% outreach_immunology_onsubmit %]>
     <input type="hidden" name="department" value="immunology" />
    <table class="indent">
      <tr>
        [% FOREACH param IN fields %]
          [% class = # highlight if param result below param lower_limit:
              lab_data.item(param).result AND # have data
              lab_data.item(param).lower_flag AND # and lower_limit
              lab_data.item(param).result < lab_data.item(param).lower_flag # data below lower_limit
            ? 'highlight' : 'normal'
          %]
          <th class="[% class %]">
            [% INCLUDE th_default_val lab_data_param = lab_data.item(param) %]
          </th>
        [% END %]
      </tr>  
			
			<tr>
			[% FOREACH param IN fields; # PROCESS dumper.tt dump = lab_data.item(param);
				# error = errs.item(param); %]
				<td>
					[% IF lab_data.item(param).field_type == 'menu' %]
								<select name="[% param %]">
									<option value="">--select one--</option>
									[% FOREACH opt IN outreach.menu_options.item(param) %]
										<option value="[% opt %]"
										[% 'selected' IF opt == lab_data.item(param).result %]>[% opt %]
										</option>
									[% END %]
								</select>
					[% ELSE %]
						<input type="text" size="3" name="[% param %]" id="[% param %]"
							value="[% lab_data.item(param).result %]" />
					[% END %]
					[% error %]
				</td>				
			[% END %]
        <td class="borderless">[% INCLUDE outreach_submit %]</td>
			</tr>
		</table>
	</form>
<!-- END [% component.name %]  -->    
