{% extends 'templates/nhs_transaction_layout.html' %}
{% import 'includes/form_macros.html' as form_macros %}

{% block afterHeader %}
  {% include "includes/service-headers/register-with-a-gp.html" %}
{% endblock %}

{% block content %}

<main id="content" role="main">

  <h1 class="heading-xlarge">
    Your personal details
  </h1>

  <form action="" method="get" class="form">

    {{
      form_macros.text_field({
        id: 'Full name',
        label: 'Your name'
      })
    }}

    {{
      form_macros.date_field({
        label: 'Date of birth',
        hint_date: '31 7 1961',
        id_prefix: 'dob-'
      })
    }}

    {% include "includes/forms/gp-practice.html" with {
      label: "Current GP practice or doctor"
    } %}

    <div class="form-group">
      <a href="application-complete" class="button">Register</a>
    </div>

  </form>
</main>

{% endblock %}

{% extends 'templates/nhs_transaction_layout.html' %}
{% import 'includes/form_macros.html' as form_macros %}

{% block afterHeader %}
  {% include "includes/service-headers/register-with-a-gp.html" %}
{% endblock %}

{% block content %}

<main id="content" role="main">

  <h1 class="heading-xlarge">
    Your personal details
  </h1>

  <form action="" method="get" class="form">

    {{
      form_macros.text_field({
        id: 'Full name',
        label: 'Your name'
      })
    }}

    {{
      form_macros.date_field({
        label: 'Your date of birth',
        hint_date: '31 7 1961',
        id_prefix: 'dob-'
      })
    }}

    <div class="form-group">
      <label class="form-label-bold" for="address-1">
        Your address
        <span class="form-hint">As you’d write it on an envelope</span>
      </label>
      <input type="text" id="address-1" class="form-control expand-bottom-quarter" value="">
      <input type="text" class="form-control expand-bottom-quarter" value="">
      <input type="text" class="form-control expand-bottom-quarter" value="">
      <input type="text" class="form-control expand-bottom-quarter" value="">
      <input type="text" class="form-control expand-bottom-quarter" value="">
      <input type="text" class="form-control expand-bottom-quarter" value="">
    </div>

    {{
      form_macros.text_field({
        id: 'telephone',
        label: 'Your telephone number'
      })
    }}

    <div class="form-group">
      <a href="your-existing-gp-details" class="button">Next</a>
    </div>

  </form>
</main>

{% endblock %}

Change fields for first registration section
Change fields for first registration section
