<!-- BEGIN [% template.name %] -->
[% #INCLUDE dumper.tt dump = request %]
<div class="container">
<div class="row">
<img src="[% request.uri_base %]/images/logo.jpg" title="LCC Logo"
border="0" align="right" alt="LCC Logo" />
</div>
<div class="row">
<fieldset><legend>HMDS Request Form</legend></fieldset>
</div>
<div class="row indent">
<h4><a href="#" id="is_trial">Request IS for clinical trial</a></h4>
<div id="trial-content" style="display: none;">
<p class="text-warning indent">
Please use specific clinical trial request form.
</p>
</div>
<h4><a href="#" id="non_trial">Request is NOT for clinical trial</a></h4>
<div id="non-trial-content" class="indent" [% # auto-open if form submission:
UNLESS params.size %]style="display: none"[% END %]>
<div class="btn-toolbar">
<form method="post" action="[% request.uri_base %]/search"
class="col-md-4 input-group">
<div class="input-group-addon">NHS number:
[% IF errs.nhs_number %]<span class="dfv-err">invalid</span>[% END %]
</div>
<input name="nhs_number" required="" id="nhs_number" type="text"
class="input-medium form-control" value="[% params.nhs_number %]"
maxlength="150" />
<span class="input-group-btn">
<button class="btn btn-primary" id="nhsno_result"
type="submit"> Search</button>
</span>
</form>
</div>
</div>
</div>
</div>
<script type="text/javascript">
$('#is_trial').click(function() {
$('#trial-content').slideToggle('fast', function() {
// ok
});
return false;
});
$('#non_trial').click(function() {
$('#non-trial-content').slideToggle('fast', function() {
// ok
});
return false;
});
// nhs number ajax validation:
$('#nhs_number').blur(function() { // alert("Handler for .blur() called.");
var formData = { 'nhs_number' : $('input[name=nhs_number]').val() };
var appMethod = "[% uri_for_nhs_number_validation %]";
$.ajax({
url: appMethod,
data: formData,
type: 'post',
dataType: 'json',
// the response is passed to the function
success: function( json ) { // alert(json.result);
$( "#nhsno_result" ).text(json.result);
},
});
// this also works as a simple 'get' request:
// $.get( appMethod, formData )
// .done( function(data) { $( "#nhsno_result" ).text(data) } );
});
</script>
<!-- END [% template.name %] -->