<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">{:__('User_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-user_id" disabled data-rule="required"  class="form-control" name="row[user_id]" type="text" value="{$row.user_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-name" class="form-control" name="row[name]" type="text" value="{$row.name|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Mobile')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-mobile" class="form-control" name="row[mobile]" type="text" value="{$row.mobile|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Email')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-email" class="form-control" name="row[email]" type="text" value="{$row.email|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Reason')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-reason" class="form-control" name="row[reason]" type="text" value="{$row.reason|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Reason_files')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-reason_files" class="form-control" size="50" name="row[reason_files]" type="text" value="{$row.reason_files|htmlentities}">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="faupload-reason_files" class="btn btn-danger faupload" data-input-id="c-reason_files" data-multiple="true" data-preview-id="p-reason_files"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-reason_files" class="btn btn-primary fachoose" data-input-id="c-reason_files" data-multiple="true"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-reason_files"></span>
            </div>
            <ul class="row list-inline faupload-preview" id="p-reason_files"></ul>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Package_order_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-package_order_id" disabled data-rule="required" data-source="packageorder/index" data-field="order_no" class="form-control selectpage" name="row[package_order_id]" type="text" value="{$row.package_order_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Sessions')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-sessions" class="form-control" name="row[sessions]" type="number" value="{$row.sessions|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('To_name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-to_name" class="form-control" name="row[to_name]" type="text" value="{$row.to_name|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('To_mobile')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-to_mobile" class="form-control" name="row[to_mobile]" type="text" value="{$row.to_mobile|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('To_email')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-to_email" class="form-control" name="row[to_email]" type="text" value="{$row.to_email|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('To_user_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-to_user_id" disabled data-rule="required" class="form-control" name="row[to_user_id]" type="text" value="{$row.to_user_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Remark')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-remark" class="form-control" name="row[remark]" type="text" value="{$row.remark|htmlentities}">
        </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="{$key}" {in name="key" value="$row.status"}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="{:$row.audittime?datetime($row.audittime):''}">
        </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="{$row.auditremark|htmlentities}">
        </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>