<!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">咸宁市遗体捐献志愿者</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：咸宁市红十字会
        </div>
        <div class="box-2">
          填表日期：
        </div>
        <div class="box-3">
          &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;年 &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;月&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;日
        </div>
        <!-- <div class="box-4">
          
        </div> -->
        <div class="box-5">
          <div>编号：&nbsp;&nbsp;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>
