<!DOCTYPE html>
<html>
<head>
<meta charset="utf-8" />
<meta name="viewport" content="width=device-width,initial-scale=1.0, minimum-scale=1.0, maximum-scale=1.0, user-scalable=no" />
<script src="layui/layui.all.js"></script>
<link rel="stylesheet" href="layui/css/layui.css">
<title></title>
</head>
<body style="background-color: #96d1d9;width: 26cm;height: 11cm;margin: 0 auto;">
<div>
<span></span>
<div class="header" style="margin-top: 1cm;width: 24cm;">
<div class="img">
<img style="height: 3cm; width: 3cm;" src="{__FRAME_PATH}img/22.png" />
</div>
<div class="left">
<div style="font-size: 31px;letter-spacing:4px">神农架林区遗体捐献志愿者</div>
<!-- <div style="margin-top: 5px;text-align: center;font-size: 30px;">入会申请登记表</div> -->
</div>
<div class="img1">
<img src="{__FRAME_PATH}img/11.png" alt="" style="height: 2cm; width: 10.5cm;">
</div>
</div>
<!-- <div class="img"></div> -->
<div class="header1" style="width: 21cm;">
<div class="box-1">
制表单位：神农架林区红十字会
</div>
<div class="box-2">
填表日期：
</div>
<div class="box-3">
年 月 日
</div>
<!-- <div class="box-4">
</div> -->
<div class="box-5">
<div>编号： YSQ-0{$arr.id}</div>
</div>
</div>
<div style="margin:8px auto;">
<table class="table table-striped table-bordered" align="center" valign="center">
<tr>
<td class="value" colspan="16" style="width: 21cm;padding: 32px 12px;text-indent: 40px; text-align: left;line-height: 38px;">
遗体捐献是服务医疗事业,造福人类的高尚行为,是“人道、博爱、奉献”精神的崇高体现。我已了解遗体捐献的基本常识和有关政策法规。我自愿登记成为遗体捐献志愿者,身故后请执行人和所有亲属尊重我的决定。
</td>
</tr>
<tr>
<td class="column" >姓名</td>
<td class="value" colspan="2">{$arr.name}</td>
<td class="column" style="width: 1cm;">性别</td>
<td class="value" colspan="2">{$arr.sex}</td>
<td class="column" style="width: 2cm;">出生年月</td>
<td class="value" colspan="5">{$arr.birthday}</td>
<!-- <td class="value"></td>
<td class="column" >性别</td>
<td class="value" colspan="1"></td>
<td class="column">民族</td>
<td class="value"></td>-->
<!-- <td class="value" rowspan="3"><img class="portrait" src="img/img04.png" /></td> -->
</tr>
<tr>
<td class="column">身份证号码</td>
<td class="value" colspan="5">{$arr.card}</td>
<td class="column" style="width: 2cm;">职业</td>
<td class="value" colspan="2">{$arr.occupation}</td>
<td class="column" style="width: 1.2cm;">学历</td>
<td class="value" colspan="2">{$arr.education}</td>
</tr>
<tr>
<!-- <td class="column">身份证号</td> -->
{if strpos($arr.remark,'全部遗体') !== false}
<td class="value" colspan="7">
<div style="display: flex;align-items: center;justify-content: center;line-height: 38px;padding: 22px 0 0 0;">
我自愿捐献全部遗体（含器官组织）<div style="width: 14px;height: 14px;border: 1px solid #333333;margin-right: 5px;">√</div>；
</div>
<div style="display: flex;align-items: center;justify-content: center;padding-bottom: 22px;">
或只捐献眼角膜<div style="width: 14px;height: 14px;border: 1px solid #333333;margin-left: 5px;margin-right: 5px;line-height: 38px;"></div>；
</div>
</td>
{else /}
<td class="value" colspan="7">
<div style="display: flex;align-items: center;justify-content: center;line-height: 38px;padding: 22px 0 0 0;">
我自愿捐献全部遗体（含器官组织）<div style="width: 14px;height: 14px;border: 1px solid #333333;margin-right: 5px;"></div>；
</div>
<div style="display: flex;align-items: center;justify-content: center;padding-bottom: 22px;">
或只捐献眼角膜<div style="width: 14px;height: 14px;border: 1px solid #333333;margin-left: 5px;margin-right: 5px;line-height: 38px;">√</div>；
</div>
</td>
{/if}
<!-- <td class="column" >联系电话</td> -->
<td class="value" colspan="5">
<div style="display: flex;align-items: center;justify-content: center;">
（ 请在选项<div style="width: 14px;height: 14px;border: 1px solid #333333;margin-right: 5px;margin-left: 5px;line-height: 38px;"></div>内打√ ）
</div>
</td>
</tr>
</table>
</div>
<div style="margin:8px auto;margin-top: 6cm;">
<table class="table table-striped table-bordered" align="center" valign="center">
<tr>
<td class="column1" rowspan="2">联系电话</td>
<!-- <td class="value" >固定电话:</td> -->
<td class="value" colspan="1" style="width: 5.8cm;text-align: left;">固定电话:{$arr.tel}</td>
<!-- <td class="value" colspan="2" style="width: 140px;"></td> -->
<td class="value" rowspan="2" colspan="14"style="width: 10cm;">
<div style="display: flex; justify-content:center;margin-left:1.8cm" >
我指定
<div style="border-bottom: 1px solid #333333; width: 3cm;display:flex;justify-content:center" >{$arr.zd_name}</div>为我的遗体捐献
</div>
<div style="text-align: left;line-height: 38px;display: flex;justify-content:center">执行人全权负责本人的遗体捐献事宜。</div>
</td>
<!-- <td class="value" colspan="12"></td> -->
<!-- <td class="value" colspan="3">15079506035</td> -->
</tr>
<tr>
<td class="value" colspan="1" style="width: 5.8cm;text-align: left;">移动电话:{$arr.phone}</td>
<!-- <td class="value" colspan="2" ></td> -->
<!-- <td class="value" colspan="3">15079506035</td> -->
</tr>
<tr>
<td class="column1" >居住地址</td>
<td class="value" colspan="8">
{$arr.address}
</td>
</tr>
<tr>
<td class="column1" >捐献执行人</td>
<td class="value" colspan="4">{$arr.executor}</td>
<td class="column1" >身份证号</td>
<td class="value" colspan="4">{$arr.sfz}</td>
</tr>
<tr >
<td class="column1" rowspan="2" style="height: 3cm;">与捐献志愿者关系</td>
<td class="value" rowspan="2" colspan="4">{$arr.relation}</td>
<td class="column1" >移动电话:</td>
<td class="value" colspan="2">{$arr.n_phone}</td>
</tr>
<tr>
<!-- <td class="value" colspan="5"></td> -->
<td class="column1" >固定电话:</td>
<td class="value" colspan="2">{$arr.n_tel}</td>
<!-- <td class="value" colspan="3">15079506035</td> -->
</tr>
<tr>
<td class="column1" >市红十字会地址</td>
<td class="value" colspan="4">武汉市江岸区胜利路162号</td>
<td class="column1" >24小时捐献电话</td>
<td class="value" colspan="4">027-82812604</td>
</tr>
</table>
</div>
<div class="footer">
我保证填写的以上信息准确真实，如发生变更或个人意愿发生变化时，及时告知登记机构。
</div>
</div>
</body>
</html>
<script type="text/javascript" src="./js/jquery.js"></script>
<script>
//一般直接写在一个js文件中
layui.use(['layer', 'form'], function() {
var layer = layui.layer,
form = layui.form;
setTimeout(function() {
$("#EleId").hide();
}, 5000);
});
</script>
<style scoped="scoped">
.footer{
margin-top: 0.8cm;
width: 26cm;
text-align: center;
/* margin: 0 auto; */
}
.header{
width: 20cm;
margin: 0 auto;
margin-top: 2cm;
display: flex;
/* justify-content: center; */
align-items: center;
margin-top: 25px;
color: #eb3223;
margin-bottom: 1cm;
letter: spacing 2;
}
.header .img{
margin-left:1.24cm;
margin-right:0.3cm;
width: 3cm;
height: 3cm;
}
.header .img1{
margin-left: 0.5cm;
}
.header1{
font-size: 18px;
/* margin-top: 134px; */
width: 1080px;
/* height: 40px; */
margin: 0 auto;
display: flex;
/* justify-content: space-around; */
}
.header1 .box-2{
margin-left: 1.2cm;
}
.header1 .box-5{
display: flex;
margin-left: 1cm;
/* width: 200px; */
/* border-bottom: 1px solid #333; */
}
.header1 .box-5 .box-6{
width: 4.2cm;
border-bottom: 1px solid #333;
}
.table {
border-collapse: collapse;
border-spacing: 0;
background-color: transparent;
display: table;
max-width: 100%;
margin: 0 auto;
}
.table td {
height: 44px;
text-align: center;
vertical-align: middle;
font-size: 18px;
font-family: 'Arial Normal', 'Arial';
color: #333333;
padding: 4px 12px;
}
.table-bordered {
border: 1px solid #ddd;
}
* {
margin: 0px;
padding: 0px;
}
.info{
width: 800px;
margin: 0 auto;
display: flex;
justify-content: space-between;
margin-top: 12px;
font-size:16px;
}
.date{
display: flex;
justify-content: flex-end;
}
.gap{
display: block;
height: 4px;
width: 26px;
}
.column {
width: 2.5cm;
height: 30px;
border: 1px solid #333;
background: #ebc5ad;
}
.column1 {
width: 145px;
height: 25px;
border: 1px solid #333;
background: #ebc5ad;
}
.box{
border: 1px solid #333;
}
.column01{
width: 100px;
height: 15px;
border: 1px solid #333;
/* background: #f1f1f1; */
}
.checkbox{
width: 20px;
height: 15px;
border: 1px solid #333;
/* justify-content: center; */
}
.box01{
margin-right: 3px;
margin-left: 3px;
}
.tpl{
width: 50px !important;
height: 15px;
border: 1px solid #333;
background: #f1f1f1;
}
.tpl01{
width: 50px !important;
height: 15px;
border: 1px solid #333;
}
.title{
font-size: 18px !important;
font-weight: bold;
}
.value {
width: 2cm;
height: 30px;
border: 1px solid #333;
}
.value1-tip{
border: 1px solid #333;
}
.value1{
width:110px;
display: inline-block;
}
.value9{
width:550px;
display: inline-block;
text-align: left;
}
.value2{
width:550px;
display: inline-block;
text-align: left;
}
.value3{
width:610px;
display: inline-block;
text-align: left;
}
.value4{
padding: 8px 0px;
}
.value5{
padding-right: 180px;
text-align: right;
}
.value6{
text-align: right;
padding: 8px 45px;
}
.value7{
text-align: right;
padding-right: 180px;
padding-top: 10px;
}
.value8{
text-align: right;
padding: 8px 45px;
}
.tp{
width: 60px;
display: inline-block;
}
.cameraCheckBoxTop{
margin-right: 8px;
width: 15px;
height: 15px;
}
.portrait {
width: 100px;
height: 100px;
}
.button-dayin{
background-color: #FF0000;
color: #FFFFFF;
width: 200px;
padding: 20px 0px;
margin: 50px auto;
text-align: center;
font-size: 30px;
}
</style>