add.html 2.8 KB

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  1. <form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">
  2. <div class="form-group">
  3. <label class="control-label col-xs-12 col-sm-2">{:__('Doctor_id')}:</label>
  4. <div class="col-xs-12 col-sm-8">
  5. <input id="c-doctor_id" data-rule="required" data-source="doctor/index" class="form-control selectpage" name="row[doctor_id]" type="text" value="">
  6. </div>
  7. </div>
  8. <div class="form-group">
  9. <label class="control-label col-xs-12 col-sm-2">{:__('Log_type')}:</label>
  10. <div class="col-xs-12 col-sm-8">
  11. <input id="c-log_type" data-rule="required" class="form-control" name="row[log_type]" type="number" value="0">
  12. </div>
  13. </div>
  14. <div class="form-group">
  15. <label class="control-label col-xs-12 col-sm-2">{:__('Before')}:</label>
  16. <div class="col-xs-12 col-sm-8">
  17. <input id="c-before" data-rule="required" class="form-control" step="0.01" name="row[before]" type="number" value="0.00">
  18. </div>
  19. </div>
  20. <div class="form-group">
  21. <label class="control-label col-xs-12 col-sm-2">{:__('Change_value')}:</label>
  22. <div class="col-xs-12 col-sm-8">
  23. <input id="c-change_value" data-rule="required" class="form-control" step="0.01" name="row[change_value]" type="number" value="0.00">
  24. </div>
  25. </div>
  26. <div class="form-group">
  27. <label class="control-label col-xs-12 col-sm-2">{:__('Remain')}:</label>
  28. <div class="col-xs-12 col-sm-8">
  29. <input id="c-remain" data-rule="required" class="form-control" step="0.01" name="row[remain]" type="number" value="0.00">
  30. </div>
  31. </div>
  32. <div class="form-group">
  33. <label class="control-label col-xs-12 col-sm-2">{:__('Table')}:</label>
  34. <div class="col-xs-12 col-sm-8">
  35. <input id="c-table" data-rule="required" class="form-control" name="row[table]" type="text" value="">
  36. </div>
  37. </div>
  38. <div class="form-group">
  39. <label class="control-label col-xs-12 col-sm-2">{:__('Table_id')}:</label>
  40. <div class="col-xs-12 col-sm-8">
  41. <input id="c-table_id" data-rule="required" data-source="table/index" class="form-control selectpage" name="row[table_id]" type="text" value="">
  42. </div>
  43. </div>
  44. <div class="form-group">
  45. <label class="control-label col-xs-12 col-sm-2">{:__('Remark')}:</label>
  46. <div class="col-xs-12 col-sm-8">
  47. <input id="c-remark" data-rule="required" class="form-control" name="row[remark]" type="text" value="">
  48. </div>
  49. </div>
  50. <div class="form-group layer-footer">
  51. <label class="control-label col-xs-12 col-sm-2"></label>
  52. <div class="col-xs-12 col-sm-8">
  53. <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
  54. </div>
  55. </div>
  56. </form>