<%@ include file="/includes.jsp"%>
<%@ taglib prefix="smvc" uri="http://www.springframework.org/tags/form"%>

<smvc:form modelAttribute="patientInfo" method="post" onsubmit = "return submitTheForm();">
<input type="hidden" name="redirectParams" value="<c:out value="${requestScope['javax.servlet.forward.query_string']}" />" />
	<table>
		<c:choose>
			<c:when test="${errorMsg != null}">
				<tr>
					<td>
					<div class="error"><img src="../images/16x16/error.png"
						alt="e" /><c:out value="${errorMsg}"/></div>
					</td>
				</tr>
			</c:when>
			<c:otherwise>
				<tr>
					<td>&nbsp;</td>
				</tr>
			</c:otherwise>
		</c:choose>
		<tr>
			<td><smvc:errors path="notes" cssClass="error"></smvc:errors></td>
		</tr>
	</table>
	<table cellspacing="0" width="850" border="0" class="table">
		<tr>
			<td width="100%">
			<table border="0" width="100%" cellspacing="0" class="table">
				<tr>
					<td width="45%" class="nrlTableTitleBar">Return To Referrer</td>
					<td width="55%" class="nrlTableTitleBar"><input type="submit"
						value="OK"  class="nrlgreenButton" /></td>
				</tr>
				<tr>
					<td colspan="2"><!-- Patient Info table --> <%@ include
						file="../common/nrlPatientInfo.jsp"%> <!-- End Patient Info table --></td>
				</tr>
				<tr>
					<td colspan="2"><!-- Patient Notes table -->
					<table width="100%" class="table" border="0" cellspacing="0"
						style="border-top: 2px solid;">
						<%@include file="../common/nrlPatientNextStep.jsp"%>
						<%@include file="../common/nrlPatientNotes.jsp"%>
					</table>
					<!-- End Patient Notes table --></td>
				</tr>
				<tr
					style="border-top: 2px solid #a8abaf; border-bottom: 2px solid #a8abaf;"
					bgcolor="#E9DDE7">
					<td colspan="2">&nbsp;</td>
				</tr>
			</table>
			</td>
		</tr>
	</table>
</smvc:form>