{% extends 'modal_base.html' %} {% load forms %} {% block icon %}{% endblock %} {% block modal_body %}
{% input "autofous" label="Drug" model="editing.drug" lookuplist="antimicrobial_list" %} {% datepicker label="Start date" model="editing.start_date" %} {% datepicker label="End date" model="editing.end_date" %} {% input label="Dose" model="editing.dose" %} {% input label="Route" model="editing.route" lookuplist="antimicrobial_route_list" %} {% input label="Frequency" model="editing.frequency" lookuplist="antimicrobial_frequency_list" %}
{% input label="Delivered by" model="editing.delivered_by" lookuplist="drug_delivered_list" %} {% select label="Adverse events" model="editing.adverse_event" lookuplist="antimicrobial_adverse_event_list" %} {% select label="Reason for Stopping" model="editing.reason_for_stopping" lookuplist="iv_stop_list" %} {% textarea label="Comments" model="editing.comments" %}
{% include 'modals/_allergies_sidebar.html' %}
{% endblock %}