{% set absUrl = app.request.getSchemeAndHttpHost() ~ app.request.baseUrl|replace({'/app_dev.php': ''}) %}
{% set userData = app.session.get('userData') %}
<!DOCTYPE html>
<html class="no-js" lang="en" dir="ltr">
<head>
	<meta charset="utf-8">
	<meta http-equiv="x-ua-compatible" content="ie=edge">
	<meta name="viewport" content="width=device-width, initial-scale=1.0">
	<title>Somnus Letter</title>
</head>
<body style="font-family:'Arial'; font-size:18px;">
{% if patientLetter.patientReferringProvider %}
	{% set rp = patientLetter.patientReferringProvider.referringProvider %}
	{% set patient = patientLetter.patient %}
	{% set receiverFullName = patientLetter.patientReferringProvider.referringProvider.honorific ~ ' ' ~ patientLetter.patientReferringProvider.referringProvider.fullName|title %}
	{% if patientLetter.patientReferringProvider.referringProvider.phoneNo is null or patientLetter.patientReferringProvider.referringProvider.phoneNo == '' %}
		{% set receiverPhone = '' %}
		{% for prhf in patient.patientReferringHealthFacilities %}
			{% for rhfp in rp.referringHealthFacilityProviders %}
				{% if prhf.referringHealthFacility.id == rhfp.referringHealthFacility.id %}
					{% set receiverPhone = prhf.referringHealthFacility.phoneNo %}
				{% endif %}
			{% endfor %}
		{% endfor %}
	{% else %}
		{% set receiverPhone = patientLetter.patientReferringProvider.referringProvider.phoneNo %}
	{% endif %}
	{% if patientLetter.patientReferringProvider.referringProvider.faxNo is null or patientLetter.patientReferringProvider.referringProvider.faxNo == '' %}
		{% set receiverFax = '' %}
		{% for prhf in patient.patientReferringHealthFacilities %}
			{% for rhfp in rp.referringHealthFacilityProviders %}
				{% if prhf.referringHealthFacility.id == rhfp.referringHealthFacility.id %}
					{% set receiverFax = prhf.referringHealthFacility.faxNo %}
				{% endif %}
			{% endfor %}
		{% endfor %}
	{% else %}
		{% set receiverFax = patientLetter.patientReferringProvider.referringProvider.faxNo %}
	{% endif %}
{% endif %}
{% if patientLetter.patientReferringHealthFacility %}
	{% set receiverFullName = patientLetter.patientReferringHealthFacility.referringHealthFacility.description %}
	{% set receiverPhone = patientLetter.patientReferringHealthFacility.referringHealthFacility.phoneNo is null ? patientLetter.patientReferringHealthFacility.referringHealthFacility.phoneNoTwo : patientLetter.patientReferringHealthFacility.referringHealthFacility.phoneNo %}
	{% set receiverFax = patientLetter.patientReferringHealthFacility.referringHealthFacility.faxNo is null ? patientLetter.patientReferringHealthFacility.referringHealthFacility.faxNoTwo : patientLetter.patientReferringHealthFacility.referringHealthFacility.faxNo %}
{% endif %}
{% if patientLetter.patientInsurance %}
	{% set receiverFullName = patientLetter.patientInsurance.insurance.description %}
	{% set receiverPhone = patientLetter.patientInsurance.insurance.phoneNo is null ? patientLetter.patientInsurance.insurance.phoneNoTwo : patientLetter.patientInsurance.insurance.phoneNo %}
	{% set receiverFax = patientLetter.patientInsurance.insurance.faxNo is null ? patientLetter.patientInsurance.insurance.faxNoTwo : patientLetter.patientInsurance.insurance.faxNo %}
{% endif %}
{% set patientFullName = patientLetter.patient.fullName %}
{% set patientFirstName = patientLetter.patient.firstName %}
{% set patientLastName = patientLetter.patient.lastName %}
{% set patient = patientLetter.patient %}
{% set dateOfBirth = patientLetter.patient.birthDate|date('F j, Y') %}

{% set customBody = patientLetter.customBody|replace({
	'{{RECEVIER-FULLNAME}}' :  receiverFullName,
	'{{PATIENT-FULLNAME}}' : patientFullName,
	'{{PATIENT-FIRSTNAME}}' :  patientLetter.patient.firstName,
	'{{PATIENT-LASTNAME}}' :  patientLetter.patient.lastName,
	'{{USERDATA-FULLNAME}}' : userData.fullName,
	'{{DATE-TODAY}}' : 'now'|date('m/d/Y'),
	'{{DATE-CREATED}}' : patientLetter.createdAt|date('m/d/Y'),
	'{{PATIENT-PHN}}' : patientLetter.patient.personalHealthNo|default(''),
	'{{PATIENT-DOB}}' : patientLetter.patient.birthDate|date('m/d/Y'),
	'{{PATIENT-GENDER}}' : patientLetter.patient.gender == 'Male' ? 'he' : 'she',
	'{{PATIENT-GENDER2}}' : patientLetter.patient.gender == 'Male' ? 'him' : 'her',
	'{{PATIENT-GENDER3}}' : patientLetter.patient.gender == 'Male' ? 'his' : 'her',
	'{{PATIENT-GENDER4}}' : patientLetter.patient.gender == 'Male' ? 'He' : 'She'
})
%}


<!------ 1ST PAGE ------>
{% include '@RxConnexion/Patient/FaxTemplate/SomnusTemplate/fax_cover.wkpdf.twig' with {patientLetter: patientLetter} %}
<div style="page-break-before: always"></div>
<div style="width:768px; position: relative; padding:0px; margin: 0 auto; box-shadow:3px 1px 10px 1px;">
	<div style="border: none;">
		<div style="color: #ED226D; font-size: 22px;"><strong>{{ quotation.title }} QUOTATION</strong></div>
		<div style="margin-bottom: 25px; margin-top: 50px;">
			<div style="margin-bottom: 50px;">Date: {{ 'now'|date('F j, Y') }}</div>
			<strong>Name: {{ patientFullName }}</strong>
			<div>Date of Birth: {{ dateOfBirth }}</div>
			{#<div>Certificate No.: {{ quotation.certificateNo|default('') }}</div>#}
			{#<div>ID Number: {{ quotation.idNo|default('') }}</div>#}
		</div>
		<div style="margin-bottom: 40px;">
			<div><strong>Diagnosis: {{ quotation.diagnosis|default('') }}</strong></div>
			<div><strong>Recommended treatment: {{ quotation.recommendedTreatment|default('') }}</strong></div>
		</div>
		<div style="margin-bottom: 60px;">The Price of the CPAP therapy are as follows with 3 years warranty from the manufacturer.</div>
		<div style="margin-bottom: 60px;">
			<table style="width: 100%; text-align: left;">
				<tr style="text-align: left;">
					<th style="border-bottom: 1px solid;"></th>
					<th style="width: 60%; border-bottom: 1px solid;">Product Name</th>
					<th style="border-bottom: 1px solid;">Price</th>
					<th style="border-bottom: 1px solid;"></th>
				</tr>
				{% set total = 0 %}
				{% if quotation.productOne or quotation.priceOne %}
					<tr>
						<td></td>
						<td>1. {{ quotation.productOne }}</td>
						<td>{{ quotation.priceOne|number_format(2, '.', ',') }}</td>
						<td></td>
					</tr>
					{% set total = quotation.priceOne %}
				{% endif %}
				{% if quotation.productTwo or quotation.priceTwo %}
					<tr>
						<td></td>
						<td>2. {{ quotation.productTwo }}</td>
						<td>{{ quotation.priceTwo|number_format(2, '.', ',') }}</td>
						<td></td>
					</tr>
					{% set total = quotation.priceOne + quotation.priceTwo %}
				{% endif %}
				{% if quotation.productThree or quotation.priceThree %}
					<tr>
						<td></td>
						<td>3. {{ quotation.productThree }}</td>
						<td>{{ quotation.priceThree|number_format(2, '.', ',') }}</td>
						<td></td>
					</tr>
					{% set total = quotation.priceOne + quotation.priceTwo + quotation.productThree %}
				{% endif %}
				{% if quotation.productFour or quotation.priceFour %}
					<tr>
						<td></td>
						<td>4. {{ quotation.productFour }}</td>
						<td>{{ quotation.priceFour|number_format(2, '.', ',') }}</td>
						<td></td>
					</tr>
					{% set total = quotation.priceOne + quotation.priceTwo + quotation.productThree + quotation.priceFour %}
				{% endif %}
				{% if quotation.productFive or quotation.priceFive %}
					<tr>
						<td></td>
						<td>5. {{ quotation.productFive }}</td>
						<td>{{ quotation.priceFive|number_format(2, '.', ',') }}</td>
						<td></td>
					</tr>
					{% set total = quotation.priceOne + quotation.priceTwo + quotation.productThree + quotation.priceFour + quotation.priceFive %}
				{% endif %}
				<tr>
					<td>&nbsp;</td>
					<td>&nbsp;</td>
					<td>&nbsp;</td>
					<td>&nbsp;</td>
				</tr>
				<tr>
					<td></td>
					<td><strong>Total:	</strong></td>
					<td><strong>{{ total|number_format(2, '.', ',') }}</strong></td>
					<td></td>
				</tr>
			</table>
		</div>
		<div>If you have questions, please feel free to contact us,</div>
		<div style="margin-bottom: 30px;">Thank you!</div>
		<div>Best regards,</div>
		<div>CPAP Pros</div>
	</div>
</div>
</body>
</html>