<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Doctor_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-doctor_id" data-rule="required" data-source="doctor/index" class="form-control selectpage" name="row[doctor_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Money')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-money" data-rule="required" class="form-control" step="0.01" name="row[money]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Plat_bilv')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-plat_bilv" data-rule="required" class="form-control" step="0.01" name="row[plat_bilv]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Plat_money')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-plat_money" data-rule="required" class="form-control" step="0.01" name="row[plat_money]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Get_money')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-get_money" data-rule="required" class="form-control" step="0.01" name="row[get_money]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Type')}:</label>
        <div class="col-xs-12 col-sm-8">
                        
            <select  id="c-type" data-rule="required" class="form-control selectpicker" name="row[type]">
                {foreach name="typeList" item="vo"}
                    <option value="{$key}" {in name="key" value="1"}selected{/in}>{$vo}</option>
                {/foreach}
            </select>

        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Acount_json')}:</label>
        <div class="col-xs-12 col-sm-8">
            
            <dl class="fieldlist" data-name="row[acount_json]">
                <dd>
                    <ins>{:__('Key')}</ins>
                    <ins>{:__('Value')}</ins>
                </dd>
                <dd><a href="javascript:;" class="btn btn-sm btn-success btn-append"><i class="fa fa-plus"></i> {:__('Append')}</a></dd>
                <textarea name="row[acount_json]" class="form-control hide" cols="30" rows="5"></textarea>
            </dl>


        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Status')}:</label>
        <div class="col-xs-12 col-sm-8">
            
            <div class="radio">
            {foreach name="statusList" item="vo"}
            <label for="row[status]-{$key}"><input id="row[status]-{$key}" name="row[status]" type="radio" value="{$key}" {in name="key" value="0"}checked{/in} /> {$vo}</label> 
            {/foreach}
            </div>

        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Audittime')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-audittime" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[audittime]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Auditremark')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-auditremark" class="form-control" name="row[auditremark]" type="text" value="">
        </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 disabled">{:__('OK')}</button>
        </div>
    </div>
</form>