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- <view class="content"><view class="top"><image src="../../static/img/application.png" mode></image></view><view class="info-box">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。我自愿登记成为武汉遗体捐献志愿者，身故后请执行人和所有亲属尊重我的决定。</view><view class="box"><view class="red-box">申请登记表</view><view class="box-1"><view class="box-left">姓名<text class="imp"></text>：</view><input class="list-input" type="text" value="{{name}}" data-event-opts="{{[['input',[['__set_model',['','name','$event',[]]]]]]}}" bindinput="__e"/></view><view class="box-1"><view class="box-left">性别：</view><picker class="box-right" value="{{index}}" range="{{array}}" data-event-opts="{{[['change',[['bindPickerSex',['$event']]]]]}}" bindchange="__e"><text>{{sex}}</text></picker></view><view class="box-1"><view class="box-left">出生年月：</view><picker class="box-right" mode="date" value="{{birthday}}" fields="month" start="{{startDate}}" end="{{endDate}}" data-event-opts="{{[['change',[['bindDateChange',['$event']]]]]}}" bindchange="__e"><view>{{birthday}}</view></picker></view><view class="box-1"><view class="box-left">身份证号码：</view><input class="list-input" type="text" value="{{card}}" data-event-opts="{{[['input',[['__set_model',['','card','$event',[]]]]]]}}" bindinput="__e"/></view><view class="box-1"><view class="box-left">职业：</view><input class="list-input" type="text" value="{{occupation}}" data-event-opts="{{[['input',[['__set_model',['','occupation','$event',[]]]]]]}}" bindinput="__e"/></view><view class="box-1"><view class="box-left">学历：</view><picker class="box-right" value="{{index}}" range="{{chooseEdu}}" data-event-opts="{{[['change',[['bindPickerEdu',['$event']]]]]}}" bindchange="__e"><text>{{education}}</text></picker></view><view class="check-box"><view class="info">（ 请在选项□内打√ )</view><radio-group data-event-opts="{{[['change',[['radioChange',['$event']]]]]}}" bindchange="__e"><block wx:for="{{items}}" wx:for-item="item" wx:for-index="index" wx:key="value"><label class="check-main"><view><radio style="transform:scale(0.7);" value="{{item.value}}" checked="{{index===current}}" color="#FF727E"></radio></view><view class="check-text">{{item.value}}</view></label></block></radio-group></view><view class="box-1"><view class="box-left">移动电话：</view><input class="list-input" type="text" data-event-opts="{{[['input',[['__set_model',['','phone','$event',[]]]]]]}}" value="{{phone}}" bindinput="__e"/></view><view class="box-1"><view class="box-left">固定电话：</view><input class="list-input" type="text" data-event-opts="{{[['input',[['__set_model',['','tel','$event',[]]]]]]}}" value="{{tel}}" bindinput="__e"/></view><view class="check-box" style="padding-left:44rpx;"><view class="info-1"><view class="info-2">我指定</view><input class="list-input" type="text" data-event-opts="{{[['input',[['__set_model',['','zd_name','$event',[]]]]]]}}" value="{{zd_name}}" bindinput="__e"/><view class="info-2">为我的遗体</view></view><view class="info-3">捐献执行人全权负责本人的遗体捐献事宜。</view></view><view class="box-1"><view class="box-left">捐献执行人：</view><input class="list-input" type="text" data-event-opts="{{[['input',[['__set_model',['','exexutor','$event',[]]]]]]}}" value="{{exexutor}}" bindinput="__e"/></view><view class="box-1"><view class="box-left">居住地址：</view><input class="list-input" type="text" data-event-opts="{{[['input',[['__set_model',['','address','$event',[]]]]]]}}" value="{{address}}" bindinput="__e"/></view><view class="box-1"><view class="box-left">身份证号码：</view><input class="list-input" type="text" data-event-opts="{{[['input',[['__set_model',['','sfz','$event',[]]]]]]}}" value="{{sfz}}" bindinput="__e"/></view><view class="box-1"><view class="box-left">与捐献志愿者关系：</view><input class="list-input" type="text" data-event-opts="{{[['input',[['__set_model',['','relation','$event',[]]]]]]}}" value="{{relation}}" bindinput="__e"/></view><view class="box-1"><view class="box-left">捐献执行人移动电话：</view><input class="list-input" type="text" data-event-opts="{{[['input',[['__set_model',['','n_phone','$event',[]]]]]]}}" value="{{n_phone}}" bindinput="__e"/></view><view class="box-1"><view class="box-left">捐献执行人固定电话：</view><input class="list-input" type="text" data-event-opts="{{[['input',[['__set_model',['','n_tel','$event',[]]]]]]}}" value="{{n_tel}}" bindinput="__e"/></view><view class="box-1"><view class="box-left">申请日期：</view><picker class="box-right" mode="date" value="{{add_time}}" fields="day" start="{{startDate}}" end="{{endDate}}" data-event-opts="{{[['change',[['fillingDateChange',['$event']]]]]}}" bindchange="__e"><view>{{add_time}}</view></picker></view><view class="box-1"><view class="box-left">我保证填写的以上信息准确真实，如发生变更或个人意愿发生变化时，及时告知登记机构。</view></view></view><view data-event-opts="{{[['tap',[['e0',['$event']]]]]}}" class="{{['buttom',(loding)?'action':'']}}" bindtap="__e">提交申请</view></view>
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