car4s/application/admin/view/user4s/user/renewal.html

<form id="renewal-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">
    {:token()}
    <div class="panel panel-warning" >
        <div class="panel-heading"><b>用户保险信息</div>
        <div class="panel-body">

            <div class="form-group">
                <label class="control-label col-xs-4 col-sm-2">姓名:</label>
                <div class="col-xs-6 col-sm-8">
                    <label class="control-label">{$row.name|htmlentities}</label>
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-4 col-sm-2">电话:</label>
                <div class="col-xs-6 col-sm-8">
                    <label class="control-label">{$row.tel|htmlentities}</label>
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-4 col-sm-2">保险公司:</label>
                <div class="col-xs-6 col-sm-8">
                    <label class="control-label">{$row.inscom|htmlentities}</label>
                </div>
            </div>
            <div class="form-group">
              <label class="control-label col-xs-4 col-sm-2">保险类型:</label>
              <div class="col-xs-6 col-sm-8">
                  <label class="control-label">{$row.instype|htmlentities}</label>
              </div>
          </div>
            <div class="form-group">
                <label class="control-label col-xs-4 col-sm-2">购买时间:</label>
                <div class="col-xs-6 col-sm-8">
                    <label class="control-label">{$row.insdate|htmlentities}</label>
                </div>
            </div>
        </div>
    </div>

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('用户满意度')}:</label>
        <div class="col-xs-12 col-sm-8">

          <select id="c-type" data-rule="required" class="form-control selectpicker" name="row[star]">
            {foreach name="all_star" item="vo"}
            <option value="{$key}" {in name="key" value="5"}selected{/in}>{$vo}</option>
            {/foreach}
          </select>

        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('续保保险公司')}:</label>
        <div class="col-xs-12 col-sm-8">
          <input id="c-inscom" class="form-control" name="row[inscom]" type="text" value="{$row.inscom|htmlentities}">
        </div>
    </div>
    <div class="form-group">
      <label class="control-label col-xs-12 col-sm-2">{:__('续保保险类型')}:</label>
      <div class="col-xs-12 col-sm-8">
        <input id="c-instype" class="form-control" name="row[instype]" type="text" value="{$row.instype|htmlentities}">
      </div>
  </div>

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('续保保险开始日期')}:</label>
        <div class="col-xs-12 col-sm-8">
          <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}">
            <span id="helpBlock" class="help-block text-warning" style="color: #f39c12;">本次续保的保险开始日期，下次将从本日期的下一年的当月当日开始提醒。</span>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Description')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-description" class="form-control" name="row[description]" type="text" value="">
            <span id="helpBlock" class="help-block">建议输入备注信息，方便后期查询。</span>
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
<style>
    .bs-callout {
  padding: 20px;
  margin: 20px 0;
  border: 1px solid #eee;
  border-left-width: 5px;
  border-radius: 3px;

  h4 {
    margin-top: 0;
    margin-bottom: 5px;
  }

  p:last-child {
    margin-bottom: 0;
  }

  code {
    border-radius: 3px;
  }

  + .bs-callout {
    margin-top: -5px;
  }
}

.bs-callout-danger {
  border-left-color: #ce4844;

  h4 {
    color: #ce4844;
  }
}

.bs-callout-warning {
  border-left-color: #aa6708;

  h4 {
    color: #aa6708;
  }
}

.bs-callout-info {
  border-left-color: #1b809e;

  h4 {
    color: #1b809e;
  }
}
</style>