multi-lot-user-incomplete-referral.html

{% 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-width-container">
  <main class="govuk-main-wrapper">
    <div class="govuk-grid-row">
      <div class="govuk-grid-column-one-third">
        <div class="govuk-form-group">
          <fieldset class="govuk-fieldset">
            <legend class="govuk-fieldset__legend govuk-fieldset__legend--m">
              <h1 class="govuk-fieldset__heading">
                Geographical area
              </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-grid-column-two-thirds">
        <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 %}