Revision 4b569058
Added by Mikaël Ates almost 12 years ago
calebasse/dossiers/templates/dossiers/patientcontact_new.html | ||
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{{ form.twinning_rank.errors }} |
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</td> |
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</tr> |
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</table> |
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<table> |
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<tr> |
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<td> |
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{{ form.parente.label_tag }} :<br> |
... | ... | |
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{{ form.phone }} |
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{{ form.phone.errors }} |
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</td> |
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</tr> |
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<tr> |
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<td> |
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{{ form.email.label_tag }} :<br> |
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{{ form.email }} |
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{{ form.email.errors }} |
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</td> |
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</tr> |
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</table> |
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<table> |
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<tr> |
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<td id="social-security-id"> |
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{{ form.social_security_id.label_tag }} :<br> |
... | ... | |
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{{ form.social_security_id.errors }} |
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<p id="nir-key">Clé : <span>-</span></p> |
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</td> |
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</tr> |
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<tr> |
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<td> |
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{{ form.begin_rights.label_tag }} :<br> |
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{{ form.begin_rights }} |
... | ... | |
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{{ form.other_health_center }} |
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{{ form.other_health_center.errors }} |
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</td> |
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</tr> |
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<tr> |
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<td> |
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{{ form.type_of_contract.label_tag }} :<br> |
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{{ form.type_of_contract }} |
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{{ form.type_of_contract.errors }} |
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</td> |
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</tr> |
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<tr> |
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<td> |
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{{ form.thirdparty_payer.label_tag }} :<br> |
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{{ form.thirdparty_payer }} |
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{{ form.thirdparty_payer.errors }} |
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</td> |
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</tr> |
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</table> |
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<table> |
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<tr> |
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<td> |
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{{ form.management_code.label_tag }} :<br> |
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{{ form.management_code }} |
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{{ form.management_code.errors }} |
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</td> |
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</tr> |
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<tr {% if object.id == request.session.patientrecord_id %}style="display: none;"{%endif%}> |
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<td> |
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{{ form.addresses.label_tag }} : |
Also available in: Unified diff
dossiers: add management_code field to PatientContact form.