edit.html 11 KB

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  1. <form id="edit-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">{:__('Nickname')}:</label>
  4. <div class="col-xs-12 col-sm-8">
  5. <input id="c-nickname" class="form-control" name="row[nickname]" type="text" value="{$row.nickname|htmlentities}">
  6. </div>
  7. </div>
  8. <div class="form-group">
  9. <label class="control-label col-xs-12 col-sm-2">{:__('Avatar')}:</label>
  10. <div class="col-xs-12 col-sm-8">
  11. <div class="input-group">
  12. <input id="c-avatar" class="form-control" size="50" name="row[avatar]" type="text" value="{$row.avatar|htmlentities}">
  13. <div class="input-group-addon no-border no-padding">
  14. <span><button type="button" id="faupload-avatar" class="btn btn-danger faupload" data-input-id="c-avatar" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp,image/webp" data-multiple="false" data-preview-id="p-avatar"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
  15. <span><button type="button" id="fachoose-avatar" class="btn btn-primary fachoose" data-input-id="c-avatar" data-mimetype="image/*" data-multiple="false"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
  16. </div>
  17. <span class="msg-box n-right" for="c-avatar"></span>
  18. </div>
  19. <ul class="row list-inline faupload-preview" id="p-avatar"></ul>
  20. </div>
  21. </div>
  22. <div class="form-group">
  23. <label class="control-label col-xs-12 col-sm-2">{:__('Gender')}:</label>
  24. <div class="col-xs-12 col-sm-8">
  25. <select id="c-gender" data-rule="required" min="0" class="form-control selectpicker" name="row[gender]">
  26. {foreach name="genderList" item="vo"}
  27. <option value="{$key}" {in name="key" value="$row.gender"}selected{/in}>{$vo}</option>
  28. {/foreach}
  29. </select>
  30. </div>
  31. </div>
  32. <div class="form-group">
  33. <label class="control-label col-xs-12 col-sm-2">{:__('Mobile')}:</label>
  34. <div class="col-xs-12 col-sm-8">
  35. <input id="c-mobile" class="form-control" name="row[mobile]" type="text" value="{$row.mobile|htmlentities}">
  36. </div>
  37. </div>
  38. <div class="form-group">
  39. <label class="control-label col-xs-12 col-sm-2">{:__('Realname')}:</label>
  40. <div class="col-xs-12 col-sm-8">
  41. <input id="c-realname" class="form-control" name="row[realname]" type="text" value="{$row.realname|htmlentities}">
  42. </div>
  43. </div>
  44. <div class="form-group">
  45. <label class="control-label col-xs-12 col-sm-2">{:__('Idcard')}:</label>
  46. <div class="col-xs-12 col-sm-8">
  47. <input id="c-idcard" class="form-control" name="row[idcard]" type="text" value="{$row.idcard|htmlentities}">
  48. </div>
  49. </div>
  50. <div class="form-group">
  51. <label class="control-label col-xs-12 col-sm-2">{:__('Idcard_z_image')}:</label>
  52. <div class="col-xs-12 col-sm-8">
  53. <div class="input-group">
  54. <input id="c-idcard_z_image" class="form-control" size="50" name="row[idcard_z_image]" type="text" value="{$row.idcard_z_image|htmlentities}">
  55. <div class="input-group-addon no-border no-padding">
  56. <span><button type="button" id="faupload-idcard_z_image" class="btn btn-danger faupload" data-input-id="c-idcard_z_image" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp,image/webp" data-multiple="false" data-preview-id="p-idcard_z_image"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
  57. <span><button type="button" id="fachoose-idcard_z_image" class="btn btn-primary fachoose" data-input-id="c-idcard_z_image" data-mimetype="image/*" data-multiple="false"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
  58. </div>
  59. <span class="msg-box n-right" for="c-idcard_z_image"></span>
  60. </div>
  61. <ul class="row list-inline faupload-preview" id="p-idcard_z_image"></ul>
  62. </div>
  63. </div>
  64. <div class="form-group">
  65. <label class="control-label col-xs-12 col-sm-2">{:__('Idcard_f_image')}:</label>
  66. <div class="col-xs-12 col-sm-8">
  67. <div class="input-group">
  68. <input id="c-idcard_f_image" class="form-control" size="50" name="row[idcard_f_image]" type="text" value="{$row.idcard_f_image|htmlentities}">
  69. <div class="input-group-addon no-border no-padding">
  70. <span><button type="button" id="faupload-idcard_f_image" class="btn btn-danger faupload" data-input-id="c-idcard_f_image" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp,image/webp" data-multiple="false" data-preview-id="p-idcard_f_image"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
  71. <span><button type="button" id="fachoose-idcard_f_image" class="btn btn-primary fachoose" data-input-id="c-idcard_f_image" data-mimetype="image/*" data-multiple="false"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
  72. </div>
  73. <span class="msg-box n-right" for="c-idcard_f_image"></span>
  74. </div>
  75. <ul class="row list-inline faupload-preview" id="p-idcard_f_image"></ul>
  76. </div>
  77. </div>
  78. <div class="form-group">
  79. <label class="control-label col-xs-12 col-sm-2">{:__('Idcard_status')}:</label>
  80. <div class="col-xs-12 col-sm-8">
  81. <div class="radio">
  82. {foreach name="idcardStatusList" item="vo"}
  83. <label for="row[idcard_status]-{$key}"><input id="row[idcard_status]-{$key}" name="row[idcard_status]" type="radio" value="{$key}" {in name="key" value="$row.idcard_status"}checked{/in} /> {$vo}</label>
  84. {/foreach}
  85. </div>
  86. </div>
  87. </div>
  88. <div class="form-group">
  89. <label class="control-label col-xs-12 col-sm-2">{:__('Doctor_image')}:</label>
  90. <div class="col-xs-12 col-sm-8">
  91. <div class="input-group">
  92. <input id="c-doctor_image" class="form-control" size="50" name="row[doctor_image]" type="text" value="{$row.doctor_image|htmlentities}">
  93. <div class="input-group-addon no-border no-padding">
  94. <span><button type="button" id="faupload-doctor_image" class="btn btn-danger faupload" data-input-id="c-doctor_image" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp,image/webp" data-multiple="false" data-preview-id="p-doctor_image"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
  95. <span><button type="button" id="fachoose-doctor_image" class="btn btn-primary fachoose" data-input-id="c-doctor_image" data-mimetype="image/*" data-multiple="false"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
  96. </div>
  97. <span class="msg-box n-right" for="c-doctor_image"></span>
  98. </div>
  99. <ul class="row list-inline faupload-preview" id="p-doctor_image"></ul>
  100. </div>
  101. </div>
  102. <div class="form-group">
  103. <label class="control-label col-xs-12 col-sm-2">{:__('Doctor_status')}:</label>
  104. <div class="col-xs-12 col-sm-8">
  105. <div class="radio">
  106. {foreach name="doctorStatusList" item="vo"}
  107. <label for="row[doctor_status]-{$key}"><input id="row[doctor_status]-{$key}" name="row[doctor_status]" type="radio" value="{$key}" {in name="key" value="$row.doctor_status"}checked{/in} /> {$vo}</label>
  108. {/foreach}
  109. </div>
  110. </div>
  111. </div>
  112. <div class="form-group">
  113. <label class="control-label col-xs-12 col-sm-2">{:__('English_status')}:</label>
  114. <div class="col-xs-12 col-sm-8">
  115. <div class="radio">
  116. {foreach name="englishStatusList" item="vo"}
  117. <label for="row[english_status]-{$key}"><input id="row[english_status]-{$key}" name="row[english_status]" type="radio" value="{$key}" {in name="key" value="$row.english_status"}checked{/in} /> {$vo}</label>
  118. {/foreach}
  119. </div>
  120. </div>
  121. </div>
  122. <div class="form-group">
  123. <label class="control-label col-xs-12 col-sm-2">{:__('Status')}:</label>
  124. <div class="col-xs-12 col-sm-8">
  125. <div class="radio">
  126. {foreach name="statusList" item="vo"}
  127. <label for="row[status]-{$key}"><input id="row[status]-{$key}" name="row[status]" type="radio" value="{$key}" {in name="key" value="$row.status"}checked{/in} /> {$vo}</label>
  128. {/foreach}
  129. </div>
  130. </div>
  131. </div>
  132. <div class="form-group">
  133. <label class="control-label col-xs-12 col-sm-2">{:__('Keshi_id')}:</label>
  134. <div class="col-xs-12 col-sm-8">
  135. <input id="c-keshi_id" data-rule="required" data-source="keshi/index" class="form-control selectpage" name="row[keshi_id]" type="text" value="{$row.keshi_id|htmlentities}">
  136. </div>
  137. </div>
  138. <div class="form-group">
  139. <label class="control-label col-xs-12 col-sm-2">{:__('Hospital')}:</label>
  140. <div class="col-xs-12 col-sm-8">
  141. <input id="c-hospital" class="form-control" name="row[hospital]" type="text" value="{$row.hospital|htmlentities}">
  142. </div>
  143. </div>
  144. <div class="form-group">
  145. <label class="control-label col-xs-12 col-sm-2">{:__('Goodat')}:</label>
  146. <div class="col-xs-12 col-sm-8">
  147. <input id="c-goodat" class="form-control" name="row[goodat]" type="text" value="{$row.goodat|htmlentities}">
  148. </div>
  149. </div>
  150. <div class="form-group">
  151. <label class="control-label col-xs-12 col-sm-2">{:__('Ordernum')}:</label>
  152. <div class="col-xs-12 col-sm-8">
  153. <input id="c-ordernum" class="form-control" name="row[ordernum]" type="number" value="{$row.ordernum|htmlentities}">
  154. </div>
  155. </div>
  156. <div class="form-group">
  157. <label class="control-label col-xs-12 col-sm-2">{:__('Level_id')}:</label>
  158. <div class="col-xs-12 col-sm-8">
  159. <input id="c-level_id" data-rule="required" data-source="doctorlevel/index" class="form-control selectpage" name="row[level_id]" type="text" value="{$row.level_id|htmlentities}">
  160. </div>
  161. </div>
  162. <div class="form-group layer-footer">
  163. <label class="control-label col-xs-12 col-sm-2"></label>
  164. <div class="col-xs-12 col-sm-8">
  165. <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
  166. </div>
  167. </div>
  168. </form>