{% extends "hostis-main.html" %} {% block head %} {{ block.super }} {% endblock %} {% block pagehead %} {% include 'hostis-pagehead.html' %} {% endblock %} {% block content %}
{% csrf_token %} {{ doctor_info_form.management_form }} {% include 'report-table-header.html' %} {% for frm in doctor_info_form %} {% endfor %}
{{ frm.id }}{{ frm.first_name }} {{ frm.middle_name }} {{ frm.last_name }} {{ frm.dea_number }} {{ frm.active }}    
      
{% csrf_token %}
{{ edit_doctor_form.id }}First Name: {{ edit_doctor_form.first_name }}    Middle Name: {{ edit_doctor_form.middle_name }}    Last Name: {{ edit_doctor_form.last_name }}    Suffix: {{ edit_doctor_form.suffix }}
Degree: {{ edit_doctor_form.degree }} DEA Number: {{ edit_doctor_form.dea_number }}    NPI #: {{ edit_doctor_form.npi }}    Active: {{ edit_doctor_form.active }}
Address: {{ edit_doctor_form.address }}    Address 2: {{ edit_doctor_form.address_2 }}
City: {{ edit_doctor_form.city }}    State: {{ edit_doctor_form.state }}    Zip: {{ edit_doctor_form.zip }}    Phone: {{ edit_doctor_form.phone }}
{% endblock %}