lanjingling/application/admin/view/order/submitordernew.html

<form id="edit-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">手机号:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-mobile" data-rule="required" class="form-control" name="user_mobile" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">联系人:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-name" data-rule="required" class="form-control" name="user_name" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">车牌号:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-car_number" data-rule="required" class="form-control" name="user_car_number" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">地址:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-address" class="form-control" name="user_address" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Servicetype_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-servicetype_id" data-rule="required" name="servicetype_id" data-source="servicetype/index" data-field="title" class="form-control selectpage" type="text" value="">
        </div>
    </div>


    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">服务时间:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-server_time" class="form-control datetimepicker" name="server_time" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" 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">服务内容:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-server_info" class="form-control" name="server_info" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">服务图片:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-server_images" class="form-control" size="50" name="server_images" type="text">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="faupload-server_images" class="btn btn-danger faupload" data-input-id="c-server_images" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp,image/webp" data-multiple="true" data-preview-id="p-server_images"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-server_images" class="btn btn-primary fachoose" data-input-id="c-server_images" data-mimetype="image/*" data-multiple="true"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-server_images"></span>
            </div>
            <ul class="row list-inline faupload-preview" id="p-server_images"></ul>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">收款金额:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-pay_fee" class="form-control" step="0.01" name="pay_fee" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">选择门店:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-company_id" data-rule="required" data-source="company/index" data-field="name" name="company_id" class="form-control selectpage" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">操作店员:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-staff_id" data-rule="required" data-source="company_staff/index" data-field="truename" name="staff_id" class="form-control selectpage" 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>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>