edit_record.html

{% extends "base.html" %}

{% block content %}
<h1 class="mb-4">Edit Health Record</h1>

<form method="POST">
    <div class="mb-3">
        <label for="patient_name" class="form-label">Patient Name</label>
        <input type="text" class="form-control" id="patient_name" name="patient_name" value="{{ record.patient_name }}" required>
    </div>
    
    <div class="mb-3">
        <label for="date_of_birth" class="form-label">Date of Birth</label>
        <input type="date" class="form-control" id="date_of_birth" name="date_of_birth" value="{{ record.date_of_birth.strftime('%Y-%m-%d') }}" required>
    </div>
    
    <div class="mb-3">
        <label for="medical_condition" class="form-label">Medical Condition</label>
        <input type="text" class="form-control" id="medical_condition" name="medical_condition" value="{{ record.medical_condition }}" required>
    </div>
    
    <div class="mb-3">
        <label for="treatment" class="form-label">Treatment</label>
        <textarea class="form-control" id="treatment" name="treatment" rows="3" required>{{ record.treatment }}</textarea>
    </div>
    
    <button type="submit" class="btn btn-primary">Update Record</button>
    <a href="{{ url_for('view_record', id=record.id) }}" class="btn btn-secondary">Cancel</a>
</form>
{% endblock %}