{# crate_anon/crateweb/consent/templates/signature_box_patient.html #} {% comment %} template parameters: patient_lookup: PatientLookup generic: bool; for any patient, not a specific patient? {% endcomment %} {% if generic %} {% else %} {% endif %}
Name:
Date of birth:
NHS number: (if known)
Address:
Signed:
Date:
Signed:
Date:
Name: {{ patient_lookup.pt_forename_surname }}
Date of birth: {{ patient_lookup.pt_dob|date }}
Identifiers: NHS number: {{ patient_lookup.nhs_number }}. {% if patient_lookup.pt_local_id_description %} {{ patient_lookup.pt_local_id_description}}: {{ patient_lookup.pt_local_id_number }}. {% endif %}