jili2/application/admin/view/house_pay/refund.html

{extend name="common/common2" /}
{block name="main"}
<div class="row">
    <div class="col-sm-12">
        <div class="ibox float-e-margins">
            <div class="ibox-content">
                <form method="post" action="{:url('refund',[],'')}/id/{$id}" class="form-horizontal">

                    <div class="form-group">
                        <label class="col-sm-2 control-label">退款金额<span class="text-danger">*</span></label>
                        <div class="col-sm-6">
                            <input type="text" class="form-control" name="money" >
                        </div>
                    </div>
                    <div class="form-group">
                        <label class="col-sm-2 control-label">姓名<span class="text-danger">*</span></label>
                        <div class="col-sm-6">
                            <input type="text" class="form-control" name="refund_name" value="{$name}" >
                        </div>
                    </div>
                    <div class="form-group">
                        <label class="col-sm-2 control-label">开户行<span class="text-danger">*</span></label>
                        <div class="col-sm-6">
                            <input type="text" class="form-control" name="refund_account">
                        </div>
                    </div>
                    <div class="form-group">
                        <label class="col-sm-2 control-label">银行卡号<span class="text-danger">*</span></label>
                        <div class="col-sm-6">
                            <input type="text" class="form-control" name="refund_bank">
                        </div>
                    </div>
                    <div class="form-group">
                        <label class="col-sm-2 control-label">退款原因<span class="text-danger">*</span></label>
                        <div class="col-sm-6">
                            <input type="text" class="form-control" name="reason">
                        </div>
                    </div>
                    <div class="hr-line-dashed"></div>
                    <div class="form-group">
                        <div class="col-sm-6 col-sm-offset-2">
                            <button class="btn btn-primary ajax-post" data-layer="1" target-form="form-horizontal" type="submit">确 定</button>
                            <button  class="btn cancel-btn btn-default" type="button">取 消</button>
                        </div>
                    </div>
                </form>
            </div>
        </div>
    </div>
</div>
{/block}
{block name="script"}
<script>


</script>
{/block}