{% extends "base.html" %} {% block head %} {% endblock %} {% block title %} Treatment Form {% endblock %} {% block content %} {% if object %}

Update treatment

{% else %}

Create treatment

{% endif %} {% if form.has_errors %}

Please correct the following error{{ form.errors|pluralize }}:

{% endif %}

{{object.patient.name}}

{% csrf_token %}

{{ form.bed }} {% if form.bed.errors %}{{ form.bed.errors }}{% endif %}

{% if form.icd9.errors %}*** {{ form.icd9.errors|join:", " }}{% endif %}

{{ form.other_diagnosis }} {% if form.other_diagnosis.errors %}{{ form.other_diagnosis.errors }}{% endif %}

{% if form.date_started.errors %}{{ form.date_started.errors }}{% endif %}

{% if form.date_completed.errors %}{{ form.date_completed.errors }}{% endif %}

{{ form.tracking_mode }} {% if form.tracking_mode.errors %}{{ form.tracking_mode.errors }}{% endif %}

{{ form.referral }} {% if form.referral.errors %}{{ form.referral.errors }}{% endif %}

{{ form.oncologist }} {% if form.oncologist.errors %}{{ form.oncologist.errors }}{% endif %}

{{ form.surgeon }} {% if form.surgeon.errors %}{{ form.surgeon.errors }}{% endif %}

{{ form.accounting }} {% if form.accounting.errors %}{{ form.accounting.errors }}{% endif %}

{{ form.karnofsky_score }} {% if form.karnofsky_score.errors %}{{ form.karnofsky_score.errors }}{% endif %}

{{ form.disease_stage }} {% if form.disease_stage.errors %}{{ form.disease_stage.errors }}{% endif %}

{{ form.primary_tumor_site }} {% if form.primary_tumor_site.errors %}{{ form.primary_tumor_site.errors }}{% endif %}

{{ form.input }} {% if form.input.errors %}{{ form.input.errors }}{% endif %}

{{ form.output }} {% if form.output.errors %}{{ form.output.errors }}{% endif %}

{{ form.complications }} {% if form.complications.errors %}{{ form.complications.errors }}{% endif %}

{{ form.chief_complaint }} {% if form.chief_complaint.errors %}{{ form.chief_complaint.errors }}{% endif %}

{{ form.memo }} {% if form.memo.errors %}{{ form.memo.errors }}{% endif %}

Return to patient
{% endblock %}