{% extends 'base_print.html.twig' %}

{% block title %}Medical Certificate of Cause of Death{% endblock %}

{% block styles %}
	{% if action_type == 'print' %}
		{{ parent() }}

		<style>
			@media print {
				@page {
					size: A4 portrait;
				}
			}

			thead th { font-weight: bold !important; }
		</style>
	{% endif %}
{% endblock %}

{% block content %}
	{% if action_type == 'print' %}
		<script>
			window.onload = function() {
				window.print();
			};
		</script>
	{% endif %}

	<div class="page-title">
		<h1 style="text-align: center;"><u>Form No. 4</u></h1>
		<h5 style="text-align: center; font-weight: bold;">(See Rule. 7)</h5>
		<h1 style="text-align: center;">Medical Certificate of Cause of Death</h1>
		<p style="text-align: center;">(Hospital in-patients, Not to be used for still births)</p>
		<p style="text-align: center; margin-bottom: 10px;">To be sent to Registrar along with Form No. 2 (Death Report)</p>

		<p>
			{{ app.user.hospital }}, I hereby certify that the person whose particulars are given below died in the hospital in
			Ward No. {{ death_certificate.case.wardBed.ward.id }} on {{ death_certificate.diedAt|date('d/m/Y') }} at {{ death_certificate.diedAt|date('g:i a') }}
		</p>
	</div>

	<section>
		<table class="mb-2">
			<thead></thead>
			<tbody>
				<tr>
					<th width="40%" style="text-align: left;">Name of Deceased</th>
					<td>{{ death_certificate.case.patient }}</td>
				</tr>
				<tr>
					<th style="text-align: left;">Age of Death</th>
					<td>{{ death_certificate.case.patient.age }}</td>
				</tr>
				<tr>
					<th style="text-align: left;">Gender</th>
					<td>{{ death_certificate.case.patient.gender }}</td>
				</tr>
				<tr>
					<th style="text-align: left;">Immediate Cause</th>
					<td>{{ death_certificate.immediateCause ? death_certificate.immediateCause : '&mdash;' }}</td>
				</tr>
				<tr>
					<th style="text-align: left;">Antecedent Cause I</th>
					<td>{{ death_certificate.antecedentCauseB ? death_certificate.antecedentCauseB : '&mdash;' }}</td>
				</tr>
				<tr>
					<th style="text-align: left;">Antecedent Cause II</th>
					<td>{{ death_certificate.antecedentCauseC ? death_certificate.antecedentCauseC : '&mdash;' }}</td>
				</tr>
				<tr>
					<th style="text-align: left;">Other Significant Conditions</th>
					<td>{{ death_certificate.otherSignificantConditions ? death_certificate.otherSignificantConditions : '&mdash;' }}</td>
				</tr>
				<tr>
					<th style="text-align: left;">Interval between on set & death approx.</th>
					<td>{{ death_certificate.onSetInterval ? death_certificate.onSetInterval : '&mdash;' }}</td>
				</tr>
				<tr>
					<th style="text-align: left;">How did the injury occur?</th>
					<td>{{ death_certificate.howInjuryOccurred ? death_certificate.howInjuryOccurred : '&mdash;' }}</td>
				</tr>
				<tr>
					<th style="text-align: left;">Manner of Death</th>
					<td>{{ death_certificate.mannerOfDeath }}</td>
				</tr>
				<tr>
					<th style="text-align: left;">Was the death associated with preganancy?</th>
					<td>{{ death_certificate.isPregnancyDeath ? 'Yes' : 'No' }}</td>
				</tr>
				<tr>
					<th style="text-align: left;">Was there a delivery?</th>
					<td>{{ death_certificate.isDelivery ? 'Yes' : 'No' }}</td>
				</tr>
			</tbody>
		</table>

		{% if action_type == 'print' %}
			<hr style="border-top: 1px dashed; #000" class="mb-5">

			<p class="text-center">(To be detached and handed over to the relative of the deseased.)</p>

			<p>
				Certified that Shri/Smt./Kum. <strong>{{ death_certificate.case.patient.firstName ~ ' ' ~ death_certificate.case.patient.lastName }}</strong> S/W/D of
				Shri <strong>{{ death_certificate.case.patient.middleName ~ ' ' ~ death_certificate.case.patient.lastName }}</strong> R/O
				<strong>{{ death_certificate.case.patient.address }}</strong> was admitted to this hospital on <strong>{{ death_certificate.case.createdAt|date('d/m/Y') }}</strong>
				and expired on <strong>{{ death_certificate.case.patient.expiredAt|date('d/m/Y') }}</strong>.
			</p>

			<div class="mt-5 float-right mr-5 pr-5">
				<p>Doctor</p>
				<p>(Medical Supdt. {{ death_certificate.case.hospital }})</p>
			</div>
		{% endif %}
	</section>
{% endblock %}