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multi-lot-user-incomplete-referral-2.html
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{% extends "layouts/main.html" %}
{% block pageTitle %}
Content page template – {{ serviceName }} – GOV.UK Prototype Kit
{% endblock %}
{% block beforeContent %}
{{ govukBackLink({
text: "Back",
href: "javascript:window.history.back()"
}) }}
{% endblock %}
{% block content %}
<div class="govuk-form-group">
<fieldset class="govuk-fieldset">
<legend class="govuk-fieldset__legend govuk-fieldset__legend--m">
<h1 class="govuk-fieldset__heading">
Geographical areas
</h1>
</legend>
<div class="govuk-checkboxes govuk-checkboxes--small" data-module="govuk-checkboxes">
<div class="govuk-checkboxes__item">
<input class="govuk-checkboxes__input" id="organisation" name="organisation" type="checkbox" value="hmrc">
<label class="govuk-label govuk-checkboxes__label" for="organisation">
LOT 1
</label>
</div>
<div class="govuk-checkboxes__item">
<input class="govuk-checkboxes__input" id="organisation-2" name="organisation" type="checkbox" value="employment-tribunal">
<label class="govuk-label govuk-checkboxes__label" for="organisation-2">
LOT 2
</label>
</div>
<div class="govuk-checkboxes__item">
<input class="govuk-checkboxes__input" id="organisation-3" name="organisation" type="checkbox" value="MOD">
<label class="govuk-label govuk-checkboxes__label" for="organisation-3">
LOT 3
</label>
</div>
<div class="govuk-checkboxes__item">
<input class="govuk-checkboxes__input" id="organisation-4" name="organisation" type="checkbox" value="DfT">
<label class="govuk-label govuk-checkboxes__label" for="organisation-4">
LOT 4
</label>
</div>
</div>
</fieldset>
</div>
<button type="submit" class="govuk-button" data-module="govuk-button">
Apply filters
</button>
</div>
<div class="govuk-width-container">
<h1 class="govuk-heading-xl">Incomplete referrals</h1>
<table class="govuk-table">
<thead class="govuk-table__head">
<tr class="govuk-table__row">
<th scope="col" class="govuk-table__header govuk-!-width-one-quarter">Surname</th>
<th scope="col" class="govuk-table__header govuk-!-width-one-quarter">First name</th>
<th scope="col" class="govuk-table__header govuk-!-width-one-quarter">Preferred name</th>
<th scope="col" class="govuk-table__header govuk-!-width-one-quarter">Nino / crn</th>
<th scope="col" class="govuk-table__header govuk-!-width-one-quarter">Date submitted</th>
<th scope="col" class="govuk-table__header govuk-!-width-one-quarter">Action</th>
</tr>
</thead>
<tbody class="govuk-table__body">
<tr class="govuk-table__row">
<td class="govuk-table__cell"> </td>
<td class="govuk-table__cell">Ben</td>
<td class="govuk-table__cell"> </td>
<td class="govuk-table__cell">T734HF54</td>
<td class="govuk-table__cell">25 January 2024</td>
<td class="govuk-table__cell"><a href="#" class="govuk-link">Update details</a></td>
</tr>
<tr class="govuk-table__row">
<td class="govuk-table__cell">Michael</td>
<td class="govuk-table__cell"> </td>
<td class="govuk-table__cell"> </td>
<td class="govuk-table__cell">SG54G5GG </td>
<td class="govuk-table__cell">27 January 2024</td>
<td class="govuk-table__cell"><a href="#" class="govuk-link">Update details</a></td>
</tr>
<tr class="govuk-table__row">
<td class="govuk-table__cell">Collins</td>
<td class="govuk-table__cell"> </td>
<td class="govuk-table__cell"> </td>
<td class="govuk-table__cell"> HYTH4564</td>
<td class="govuk-table__cell">28 December 2024</td>
<td class="govuk-table__cell"><a href="#" class="govuk-link">Update details</a></td>
</tr>
<tr class="govuk-table__row">
<td class="govuk-table__cell"> </td>
<td class="govuk-table__cell">Jack</td>
<td class="govuk-table__cell"> </td>
<td class="govuk-table__cell">CDE4435C</td>
<td class="govuk-table__cell">20 January 2024</td>
<td class="govuk-table__cell"><a href="#" class="govuk-link">Update details</a></td>
</tr>
</tbody>
</table>
</div>
</div>
</main>
</div>
{% endblock %}