Sha256: 9cd7860ee6596b0aa3b9165485d46d2b3540e7fbe5d53152004b9429c4336325
Contents?: true
Size: 1.22 KB
Versions: 149
Compression:
Stored size: 1.22 KB
Contents
= within_patient_layout(title: "Cause of Death",
breadcrumbs: breadcrumb_for("Clinical Profile", patient_clinical_profile_path(patient))) do
= simple_form_for patient,
url: patient_death_path(patient),
html: { autocomplete: "off" },
wrapper: "horizontal_form" do |f|
= f.input :died_on,
as: :date_picker,
label: "Date of Death",
wrapper: :horizontal_datepicker
= f.association :first_cause,
label: "Cause of Death (1)",
label_method: :description,
value_method: :id,
include_blank: "Select 1st cause of death",
wrapper: :horizontal_medium
= f.association :second_cause,
label: "Cause of Death (2)",
label_method: :description,
value_method: :id,
include_blank: "Select 2nd cause of death",
wrapper: :horizontal_medium
= f.input :death_notes,
label: "Notes",
as: :text, input_html: { rows: 5 },
wrapper: :horizontal_large
= f.button :submit
span= " or "
= link_to "cancel", patient_clinical_profile_path(patient)
Version data entries
149 entries across 149 versions & 1 rubygems