{# 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 %}
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 %} |