<html lang="en">
<head>

    <title></title>
    <meta charset="utf-8" />
    <link href="https://fonts.googleapis.com/css?family=Dawning+of+a+New+Day" rel="stylesheet">

    <style type="text/css">
        body {
            font-family:arial, sans-serif;
            font-size:14px;
            margin: 0;
            padding: 0;
            color: #000;
        }

        p {
            padding: 0;
            margin: 0;
        }

        td {
            padding: 0;
            vertical-align: top;
            line-height: 24px;
        }

    </style>

</head>
<body>

<table>
    <tr>
        <td width="55%">{{ doctor_surgery.practice_name }}<br />
            {{ doctor_surgery.address_1 }}<br />
            {% if doctor_surgery.address_2 is not empty %}
                {{ doctor_surgery.address_2 }}
                {% if doctor_surgery.address_3 is not empty %}
                    , {{ doctor_surgery.address_3 }}
                {% endif %}
                <br />
            {% endif %}
            {{ doctor_surgery.city }}<br />
            {{ doctor_surgery.postcode }}
        </td>
        <td width="45%" align="right">
            <table>
                {% if doctor_surgery.phone is not empty %}
                    <tr>
                        <td width="30%" align="left" style="color:#888;">Phone:</td>
                        <td width="70%" align="left">{{ doctor_surgery.phone }}</td>
                    </tr>
                {% endif %}
                {% if doctor_surgery.fax is not empty %}
                    <tr>
                        <td align="left" style="color:#888;">Fax:</td>
                        <td align="left">{{ doctor_surgery.fax }}</td>
                    </tr>
                {% endif %}
                {% if doctor_surgery.email is not empty %}
                    <tr>
                        <td align="left" style="color:#888;">Email:</td>
                        <td align="left">{{ doctor_surgery.email }}</td>
                    </tr>
                {% endif %}
            </table>
        </td>
    </tr>
</table>
<br />
<p>Please supply the following repeat prescription via EPS:</p>

<table>
    <tr>
        <td width="20%" style="color:#888;">Name:</td>
        <td width="80%">{{ nhs_member.firstname }} {{ nhs_member.lastname }}</td>
    </tr>
    <tr>
        <td style="color:#888;">Date of Birth:</td>
        <td>{{ (nhs_member.dob)|date('d/m/Y') }}</td>
    </tr>
    <tr>
        <td style="color:#888;">Address:</td>
        <td>{{ nhs_member.member.addressBilling.address1 }} {{ nhs_member.member.addressBilling.address2 }}, {{ nhs_member.member.addressBilling.city }}, {{ nhs_member.member.addressBilling.postcode }}</td>
    </tr>
    <tr>
        <td style="color:#888;">Telephone:</td>
        <td>{{ nhs_member.member.contact_no }}</td>
    </tr>
</table>

<p style="text-align: justify; line-height: 20px;">I am the patient named above and I would like to nominate {{ config('app.name') }} (2UP Pharmacy) to manage electronic prescriptions on my behalf with my registered GP surgery. I understand that this will enable {{ config('app.name') }} (2UP Pharmacy) to receive my prescriptions via Electronic Transfer of Prescription (ETP); I am also happy for {{ config('app.name') }} (2UP Pharmacy) to contact myself or my GP surgery to verify my prescription items, make queries about the items, or to advise me that my prescription is ready.</p>

<p>My nominated dispenser:</p>

<p style="font-size:13px;"><strong>{{ config('app.name') }} (2UP Pharmacy), 18a North Street, Keighley, UK BD21 3SE - 01535 685961</strong></p>

<table>
    <tr>
        <td style="border-top:1px solid #CCC; border-bottom:1px solid #CCC; height: 330px;"><br /><br />{% for order_item in order.items %}&bull; {{ order_item.item_name }}<br />{% endfor %}</td>
    </tr>
</table>

<table>
    <tr>
        <td width="20%" style="color:#888; line-height: 30px;">Signed:</td>
        <td width="80%" style="line-height: 30px; font-family: 'amandasignaturei', cursive;">{{ nhs_member.firstname }} {{ nhs_member.lastname }}</td>
    </tr>
    <tr>
        <td width="20%" style="color:#888; line-height: 30px;">Date:</td>
        <td width="80%" style="line-height: 30px;">{{ (order.date)|date('d/m/Y') }}</td>
    </tr>
</table>

</body>
</html>
