124 lines
4.0 KiB
HTML
124 lines
4.0 KiB
HTML
<form id="renewal-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">
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{:token()}
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<div class="panel panel-warning" >
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<div class="panel-heading"><b>用户保险信息</div>
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<div class="panel-body">
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<div class="form-group">
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<label class="control-label col-xs-4 col-sm-2">姓名:</label>
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<div class="col-xs-6 col-sm-8">
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<label class="control-label">{$row.name|htmlentities}</label>
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</div>
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</div>
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<div class="form-group">
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<label class="control-label col-xs-4 col-sm-2">电话:</label>
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<div class="col-xs-6 col-sm-8">
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<label class="control-label">{$row.tel|htmlentities}</label>
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</div>
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</div>
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<div class="form-group">
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<label class="control-label col-xs-4 col-sm-2">保险类型:</label>
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<div class="col-xs-6 col-sm-8">
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<label class="control-label">{$row.inscom|htmlentities}</label>
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</div>
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</div>
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<div class="form-group">
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<label class="control-label col-xs-4 col-sm-2">购买时间:</label>
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<div class="col-xs-6 col-sm-8">
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<label class="control-label">{$row.insdate|htmlentities}</label>
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</div>
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</div>
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</div>
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</div>
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<div class="form-group">
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<label class="control-label col-xs-12 col-sm-2">{:__('用户满意度')}:</label>
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<div class="col-xs-12 col-sm-8">
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<select id="c-type" data-rule="required" class="form-control selectpicker" name="row[star]">
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{foreach name="all_star" item="vo"}
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<option value="{$key}" {in name="key" value=""}selected{/in}>{$vo}</option>
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{/foreach}
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</select>
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</div>
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</div>
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<div class="form-group">
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<label class="control-label col-xs-12 col-sm-2">{:__('续保保险类型')}:</label>
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<div class="col-xs-12 col-sm-8">
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<input id="c-inscom" class="form-control" name="row[inscom]" type="text" value="{$row.inscom|htmlentities}">
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</div>
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</div>
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<div class="form-group">
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<label class="control-label col-xs-12 col-sm-2">{:__('续保保险时间')}:</label>
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<div class="col-xs-12 col-sm-8">
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<input id="c-insdate" class="form-control datetimepicker" data-date-format="YYYY-MM-DD" data-use-current="true" name="row[insdate]" type="text" value="{$now}">
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<span id="helpBlock" class="help-block">本次续保的保险开始时间，方便下次提醒。</span>
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</div>
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</div>
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<div class="form-group">
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<label class="control-label col-xs-12 col-sm-2">{:__('Description')}:</label>
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<div class="col-xs-12 col-sm-8">
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<input id="c-description" class="form-control" name="row[description]" type="text" value="">
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<span id="helpBlock" class="help-block">建议输入备注信息，方便后期查询。</span>
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</div>
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</div>
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<div class="form-group layer-footer">
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<label class="control-label col-xs-12 col-sm-2"></label>
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<div class="col-xs-12 col-sm-8">
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<button type="submit" class="btn btn-primary btn-embossed">{:__('OK')}</button>
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<button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
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</div>
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</div>
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</form>
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<style>
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.bs-callout {
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padding: 20px;
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margin: 20px 0;
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border: 1px solid #eee;
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border-left-width: 5px;
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border-radius: 3px;
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h4 {
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margin-top: 0;
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margin-bottom: 5px;
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}
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p:last-child {
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margin-bottom: 0;
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}
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code {
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border-radius: 3px;
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}
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+ .bs-callout {
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margin-top: -5px;
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}
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}
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.bs-callout-danger {
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border-left-color: #ce4844;
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h4 {
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color: #ce4844;
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}
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}
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.bs-callout-warning {
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border-left-color: #aa6708;
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h4 {
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color: #aa6708;
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}
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}
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.bs-callout-info {
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border-left-color: #1b809e;
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h4 {
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color: #1b809e;
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}
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}
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</style> |