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<!DOCTYPE html>
<html>
<head>
<meta charset="utf-8">
<link href="https://fonts.googleapis.com/icon?family=Material+Icons" rel="stylesheet">
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/materialize/1.0.0/css/materialize.min.css">
<title></title>
</head>
<body>
<main style="margin-left: 10px;margin-right: 10px;margin-top: 10px;">
<ul class="collection">
<li class="collection-item">
{% if doc.0.status == "wait" %}
<i class="material-icons left">timelapse</i>
{% elif doc.0.status == "ok" %}
<i class="material-icons left">check</i>
{% elif doc.0.status == "archive" %}
<i class="material-icons left">archive</i>
{% elif doc.0.status == "autosign" %}
<i class="material-icons left">assignment_turned_in</i>
{% endif %}
{{doc.0.document_type.name}}
<span class="badge" data-badge-caption="">{{doc.0.user.username}}</span>
</li>
{% if doc.0.status == 'ok' or doc.0.status == 'archive' %}
<li class="collection-item">
<i class="material-icons left">confirmation_number</i>{{doc.0.code}}
</li>
{% endif %}
<li class="collection-item">
<i class="material-icons left">send</i>{{doc.0.compilation_date}}
</li>
{% if doc.0.document_type.personal_data %}
<li class="collection-item">
<i class="material-icons left">person</i>Dati personali
<br><br>
<div class="row">
<div class="input-field col l4 s12">
<input placeholder=" " value="{{doc.0.user.first_name}}" id="first_name" type="text" >
<label class="active" for="first_name">Nome</label>
</div>
<div class="input-field col l4 s12">
<input placeholder=" " value="{{doc.0.user.last_name}}" id="last_name" type="text" >
<label class="active" for="last_name">Cognome</label>
</div>
<div class="input-field col l4 s12">
<input placeholder=" " value="{{doc.2.born_date}}" id="birth_date" type="text">
<label class="active" for="birth_date">Data di nascita</label>
</div>
<div class="input-field col l4 s12">
<input placeholder=" " value="{{doc.4}}" id="branca" type="text">
<label class="active" for="branca">Branca</label>
</div>
<div class="input-field col l4 s12">
<input placeholder=" " value="{{doc.2.parent_name}}" id="parent_name" type="text" >
<label class="active" for="parent_name">Nome dei genitori</label>
</div>
<div class="input-field col l4 s12">
<input placeholder=" " value="{{doc.2.avs_number}}" id="avs_number" type="text">
<label for="avs_number">Numero AVS</label>
</div>
<div class="input-field col l12 s12">
<input placeholder=" " value="{{doc.2.via}}" id="via" type="text" >
<label class="active" for="via">Via e numero</label>
</div>
<div class="input-field col l4 s12">
<input placeholder=" " value="{{doc.2.cap}}" name="cap" id="cap" type="text" >
<label class="active" for="cap">CAP</label>
</div>
<div class="input-field col l4 s12">
<input placeholder=" " value="{{doc.2.country}}" name="country" id="country" type="text" >
<label class="active" for="country">Comune</label>
</div>
<div class="input-field col l4 s12">
<input placeholder=" " value="{{doc.2.nationality}}" name="nationality" id="nationality" type="text" >
<label class="active" for="nationality">Nazionalità</label>
</div>
<div class="input-field col l4 s12">
<input placeholder=" " value="{{doc.2.phone}}" name="phone" id="phone" type="text" >
<label class="active" for="phone">Cellulare</label>
</div>
<div class="input-field col l4 s12">
<input placeholder=" " value="{{doc.2.home_phone}}" name="home_phone" id="home_phone" type="text" >
<label class="active" for="home_phone">Telefono di casa</label>
</div>
<div class="input-field col l4 s12">
<input placeholder=" " value="{{doc.2.email}}" name="email" id="email" type="text" >
<label class="active" for="email">Email</label>
</div>
<div class="input-field col l8 s12">
<input placeholder=" " value="{{doc.2.school}}" name="school" id="school" type="text" >
<label class="active" for="school">Scuola frequentata</label>
</div>
<div class="input-field col l4 s12">
<input placeholder=" " value="{{doc.2.year}}" name="year" id="year" type="text" >
<label class="active" for="year">Classe</label>
</div>
</div>
</li>
{% endif %}
{% if doc.0.document_type.medical_data %}
<li class="collection-item">
<i class="material-icons left">healing</i>Dati medici
<br><br>
<div class="row">
<div class="col s12">
<h6>Persona di contatto in caso di necessità</h6>
</div>
</div>
<div class="row">
<div class="input-field col l6 s12">
<input placeholder=" " name="emer_name" value="{{doc.3.emer_name}}" id="emer_name" type="text" >
<label class="active" for="emer_name">Nome e cognome</label>
</div>
<div class="input-field col l3 s12">
<input placeholder=" " name="emer_relative" value="{{doc.3.emer_relative}}" id="emer_relative" type="text" >
<label class="active" for="emer_releative">Parentela</label>
</div>
<div class="input-field col l3 s12">
<input placeholder=" " name="cell_phone" value="{{doc.3.cell_phone}}" id="cellphone" type="text" >
<label class="active" for="cell_phone">Cellulare</label>
</div>
<div class="input-field col l9 s12">
<input placeholder=" " value="{{doc.3.address}}" name="address" id="address" type="text" >
<label class="active" for="address">Indirizzo completo</label>
</div>
<div class="input-field col l3 s12">
<input placeholder=" " value="{{doc.3.emer_phone}}" name="emer_phone" id="emer_phone" type="text" >
<label class="active" for="emer_phone">Telefono di casa</label>
</div>
</div>
<div class="row">
<div class="col s12">
<h6>Assicurazione</h6>
</div>
</div>
<div class="row">
<div class="input-field col l4 s12">
<input placeholder=" " value="{{doc.3.health_care}}" name="health_care" id="health_care" type="text" >
<label class="active" for="health_care">Cassa Malati</label>
</div>
<div class="input-field col l4 s12">
<input placeholder=" " value="{{doc.3.injuries}}" name="injuries" id="injuries" type="text" >
<label class="active" for="injuries">Infortuni</label>
</div>
<div class="input-field col l4 s12">
<input placeholder=" " value="{{doc.3.rc}}" name="rc" id="rc" type="text" >
<label class="active" for="rc">Responsabilità civile</label>
</div>
</div>
<div class="row">
<div class="switch col s12">
È sostenitore REGA
<label>
No
<input name="rega" type="checkbox" {% if doc.3.rega %}checked="checked"{%endif%}>
<span class="lever"></span>
Si
</label>
</div>
</div>
<div class="row">
<div class="col s12">
<h6>Medico di famiglia</h6>
</div>
<div class="input-field col l6 s12">
<input placeholder=" " value="{{doc.3.medic_name}}" name="medic_name" id="medic_name" type="text" >
<label class="active" for="medic_name">Nome e cognome</label>
</div>
<div class="input-field col l6 s12">
<input placeholder=" " value="{{doc.3.medic_phone}}" name="medic_phone" id="medic_phone" type="text" >
<label class="active" for="medic_phone">Telefono studio</label>
</div>
<div class="input-field col l12 s12">
<input placeholder=" " value="{{doc.3.medic_address}}" name="medic_address" id="medic_address" type="text" >
<label class="active" for="medic_address">Indirizzo completo</label>
</div>
</div>
<div class="row">
<div class="col s12">
<h6>Scheda medica personale</h6>
</div>
<div class="input-field col s12">
<input placeholder=" " value="{{doc.3.sickness}}" name="sickness" id="sickness" type="text">
<label class="active" for="sickness">Principali malattie avute</label>
</div>
<div class="input-field col l8 s12">
<input placeholder=" " value="{{doc.3.vaccine}}" name="vaccine" id="vaccine" type="text">
<label class="active" for="vaccine">Vacinazioni fatte</label>
</div>
<div class="input-field col l4 s12">
<label class="active" for="tetanus_date">Ultima vacinazione contro il tetano</label>
<input placeholder=" " value="{{doc.3.tetanus_date}}" name="tetanus_date" id="tetanus_date" type="text">
</div>
<div class="input-field col s12">
<input placeholder=" " value="{{doc.3.allergy}}" name="allergy" id="allergy" type="text">
<label class="active" for="allergy">Allergie particolari/Intolleraze alimentari</label>
</div>
<div class="switch col s12">
Deve assumere regolarmente medicamenti
<label>
No
<input name="drugs_bool" type="checkbox" {% if doc.3.drugs_bool %}checked="checked"{%endif%}>
<span class="lever"></span>
Si
</label>
</div>
<div class="input-field col s12">
<input placeholder=" " value="{{doc.3.drugs}}" name="drugs" id="drugs" type="text">
<label class="active" for="drugs">Se sì quali, in che dosi e prescrizioni</label>
</div>
<div class="switch col s12">
Informazioni particolari sullo stato di salute: (postumi di operazioni, incidenti, malattie, disturbi fisici)
<label>
No
<input name="misc_bool" type="checkbox" {% if doc.3.misc_bool %}checked="checked"{%endif%}>
<span class="lever"></span>
Si
</label>
</div>
<div class="input-field col s12">
<input placeholder=" " value="{{doc.3.misc}}" name="misc" id="misc" type="text">
<label class="active" for="misc">Se sì quali</label>
</div>
</div>
</li>
{% endif %}
{% if doc.0.document_type.custom_data %}
<li class="collection-item">
<i class="material-icons left">add_circle_outline</i>Dati aggiuntivi
<br><br>
<table class="striped">
<tbody>
{% for key in doc.1 %}
<tr>
<td>{{key.key}}</td>
<td>{{key.value}}</td>
</tr>
{% endfor %}
</tbody>
</table>
</li>
{% endif %}
{% if doc.0.document_type.medical_data %}
<li class="collection-item">
<i class="material-icons left">attach_file</i>Allegati
<br><br>
<div class="row">
<div class="col s12">
<div class="card">
<div class="card-image">
{% if vac %}<img src="data:;base64,{{ vac }}">{% endif %}
</div>
</div>
</div>
</div>
<div class="row">
<div class="col s12">
<div class="card">
<div class="card-image">
{% if health %}<img src="data:;base64,{{ health }}">{% endif %}
</div>
</div>
</div>
</div>
<div class="row">
<div class="col s12">
<div class="card">
<div class="card-image">
{% if sign_doc_file %}<img src="data:;base64,{{ sign_doc_file }}">{% endif %}
</div>
</div>
</div>
</div>
</li>
{% endif %}
</ul>
</form>
</main>
</body>
<script type="text/javascript" src="https://cdnjs.cloudflare.com/ajax/libs/materialize/1.0.0/js/materialize.min.js"></script>
</html>
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