edit.html 8.9 KB

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  1. {extend name="common/common2" /}
  2. {block name="main"}
  3. <div class="row">
  4. <div class="col-sm-12">
  5. <div class="ibox float-e-margins">
  6. <div class="ibox-title">
  7. <h5>{$meta_title}</h5>
  8. <div class="ibox-tools">
  9. <a class="toback" href="javascript:;" onclick="window.history.back()">
  10. 返回上一页
  11. </a>
  12. </div>
  13. </div>
  14. <div class="ibox-content">
  15. <form method="post" action="{:url('edit')}" class="form-horizontal">
  16. <input type="hidden" name="id" value="{$info['id']|default='0'}">
  17. <div class="col-xs-6">
  18. <div class="form-group">
  19. <label class="col-xs-3 control-label">联系人 <span class="text-danger">*</span></label>
  20. <div class="col-xs-9">
  21. <input type="text" class="form-control" name="contact" value="{$info.contact|default=''}">
  22. </div>
  23. </div>
  24. </div>
  25. <div class="col-xs-6">
  26. <div class="form-group">
  27. <label class="col-xs-3 control-label">联系手机号 <span class="text-danger">*</span></label>
  28. <div class="col-xs-9">
  29. <input type="text" class="form-control" name="phone" value="{$info.phone|default=''}">
  30. </div>
  31. </div>
  32. </div>
  33. <div class="col-xs-6">
  34. <div class="form-group">
  35. <label class="col-xs-3 control-label">病人姓名</label>
  36. <div class="col-xs-9">
  37. <input type="text" class="form-control" name="name" value="{$info.name|default=''}">
  38. </div>
  39. </div>
  40. </div>
  41. <div class="col-xs-6">
  42. <div class="form-group">
  43. <label class="col-xs-3 control-label">性别</label>
  44. <div class="col-xs-9">
  45. <select name="gender" class="form-control">
  46. <option value="1">男</option>
  47. <option value="2">女</option>
  48. </select>
  49. </div>
  50. </div>
  51. </div>
  52. <div class="col-xs-6">
  53. <div class="form-group">
  54. <label class="col-xs-3 control-label">年龄</label>
  55. <div class="col-xs-9">
  56. <input type="text" class="form-control" name="age" value="{$info.age|default=''}">
  57. </div>
  58. </div>
  59. </div>
  60. <div class="col-xs-6">
  61. <div class="form-group">
  62. <label class="col-xs-3 control-label">床号</label>
  63. <div class="col-xs-9">
  64. <input type="text" class="form-control" name="bed" value="{$info.bed|default=''}">
  65. </div>
  66. </div>
  67. </div>
  68. <div class="col-xs-6">
  69. <div class="form-group">
  70. <label class="col-xs-3 control-label">所患疾病</label>
  71. <div class="col-xs-9">
  72. <input type="text" class="form-control" name="ill" value="{$info.ill|default=''}">
  73. </div>
  74. </div>
  75. </div>
  76. <div class="col-xs-6">
  77. <div class="form-group">
  78. <label class="col-xs-3 control-label">订单金额</label>
  79. <div class="col-xs-9">
  80. <input type="text" class="form-control" name="amount" value="{$info.amount|default=''}">
  81. </div>
  82. </div>
  83. </div>
  84. <div class="col-xs-6">
  85. <div class="form-group">
  86. <label class="col-xs-3 control-label">开始时间</label>
  87. <div class="col-xs-9">
  88. <input type="text" class="form-control" readonly id="start" name="start" value="{$info.start|default=''}">
  89. </div>
  90. </div>
  91. </div>
  92. <div class="col-xs-6">
  93. <div class="form-group">
  94. <label class="col-xs-3 control-label">结束时间</label>
  95. <div class="col-xs-9">
  96. <input type="text" class="form-control" readonly id="end" name="end" value="{$info.end|default=''}">
  97. </div>
  98. </div>
  99. </div>
  100. <div class="form-group">
  101. <label class="col-sm-2 control-label">科室/部门</label>
  102. <div class="col-sm-7">
  103. <select name="dep_id" class="form-control">
  104. <option value="0">选择科室/部门</option>
  105. {volist name="dep" id="v"}
  106. <option value="{$v.id}">{$v.title}</option>
  107. {/volist}
  108. </select>
  109. </div>
  110. </div>
  111. <div class="form-group">
  112. <label class="col-sm-2 control-label">陪护服务</label>
  113. <div class="col-sm-7">
  114. <select name="cate_id" class="form-control" onchange="changeService(this)">
  115. <option value="0">选择服务</option>
  116. {volist name="cate" id="v"}
  117. <option value="{$v.id}">{$v.title}</option>
  118. {/volist}
  119. </select>
  120. </div>
  121. </div>
  122. <div class="form-group">
  123. <label class="col-sm-2 control-label">价格(/人/天)</label>
  124. <div class="col-sm-7">
  125. <input type="text" class="form-control" id="price" name="price" value="{$info.price|default=''}">
  126. </div>
  127. </div>
  128. <!-- <div class="form-group">-->
  129. <!-- <label class="col-sm-2 control-label">预收金</label>-->
  130. <!-- <div class="col-sm-7">-->
  131. <!-- <input type="number" class="form-control" name="pre_money" value="{$info.pre_money|default=''}">-->
  132. <!-- </div>-->
  133. <!-- </div>-->
  134. <div class="hr-line-dashed"></div>
  135. <div class="form-group">
  136. <div class="col-sm-4 col-sm-offset-2">
  137. <button class="btn btn-primary ajax-post" target-form="form-horizontal" type="submit">确 定</button>
  138. <a href="{:url('index')}" class="btn btn-default">取 消</a>
  139. </div>
  140. </div>
  141. </form>
  142. </div>
  143. </div>
  144. </div>
  145. </div>
  146. {/block}
  147. {block name="script"}
  148. <script type="text/javascript" src="/static/layDate-v5.0.9/laydate.js"></script>
  149. <script>
  150. laydate.render({
  151. elem: '#start',
  152. //设置开始日期、日期日期的 input 选择器
  153. //数组格式为 5.3.0 开始新增,之前版本直接配置 true 或任意分割字符即可
  154. type: 'datetime',
  155. trigger: 'click',
  156. theme: '#148d8f'
  157. });
  158. laydate.render({
  159. elem: '#end',
  160. //设置开始日期、日期日期的 input 选择器
  161. //数组格式为 5.3.0 开始新增,之前版本直接配置 true 或任意分割字符即可
  162. type: 'datetime',
  163. trigger: 'click',
  164. theme: '#148d8f'
  165. });
  166. var cates = JSON.parse('{:json_encode($cate)}');
  167. function changeService(_self) {
  168. console.log(cates);
  169. var cateId = $(_self).val();
  170. var price = '';
  171. console.log(cateId);
  172. for (let o in cates){
  173. if(cates[o].id == cateId){
  174. price = cates[o].price;
  175. break;
  176. }
  177. }
  178. console.log(price);
  179. $('#price').val(price);
  180. }
  181. $(document).ready(function(){
  182. formSetValue("cate_id", {$info.cate_id|default=0});
  183. formSetValue("dep_id", {$info.dep_id|default=0});
  184. });
  185. </script>
  186. {/block}