Project

General

Profile

Download (940 Bytes) Statistics
| Branch: | Tag: | Revision:

calebasse / calebasse / dossiers / templates / dossiers / generate_transport_prescription_form.html @ dc526631

1
{% load widget_tweaks %}
2

    
3
    <form action="{{ request.get_full_path }}" method="post">
4
      {% csrf_token %}
5

    
6
    <h2>Patient {{ object.first_name }} <span class="lastname">{{ object.last_name }}</span></h2>
7
    {% if object.id != object.policyholder.id %}<strong>Assuré {{ object.policyholder.first_name }} <span class="lastname">{{ object.policyholder.last_name }}</span></strong>{% endif %}
8

    
9
    {% if not object.policyholder.addresses.all %}
10
        L'assuré n'a pas d'adresse connue.
11
    {% else %}
12
    <h2>Adresse</h2>
13

    
14
    <ul class="addresses">
15
      {% for address in object.policyholder.addresses.all %}
16
        <li><input type="radio" name="address_id" id="address_{{ address.id }}" value="{{ address.id }}"><label for="address_{{ address.id }}">{% if address.display_name %}{{ address.display_name }}{% else %}Adresse non renseignée.{% endif %}</label></input></li>
17
      {% endfor %}
18
    </ul>
19
    {% endif %}
20
    </form>
(3-3/20)