add.html 6.4 KB

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  1. <form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">
  2. {eq name="admin.cid" value="0"}
  3. <div class="form-group">
  4. <label class="control-label col-xs-12 col-sm-2">{:__('Cid')}:</label>
  5. <div class="col-xs-12 col-sm-8">
  6. <input id="c-cid" data-rule="required" data-source="Company" data-field="company_name" class="form-control selectpage" name="row[cid]" type="text" >
  7. </div>
  8. </div>
  9. {else/}
  10. <input id="c-cid" name="row[cid]" type="hidden" value="{$admin.cid}">
  11. {/eq}
  12. <div class="form-group">
  13. <label class="control-label col-xs-12 col-sm-2">{:__('Help_id')}:</label>
  14. <div class="col-xs-12 col-sm-8">
  15. <input id="c-help_id" data-rule="required" data-source="help/index" class="form-control selectpage" name="row[help_id]" type="text" value="">
  16. </div>
  17. </div>
  18. <div class="form-group">
  19. <label class="control-label col-xs-12 col-sm-2">{:__('Sex')}:</label>
  20. <div class="col-xs-12 col-sm-8">
  21. <select id="c-sex" data-rule="required" class="form-control selectpicker" name="row[sex]">
  22. {foreach name="sexList" item="vo"}
  23. <option value="{$key}" {in name="key" value="0"}selected{/in}>{$vo}</option>
  24. {/foreach}
  25. </select>
  26. </div>
  27. </div>
  28. <div class="form-group">
  29. <label class="control-label col-xs-12 col-sm-2">{:__('Politics')}:</label>
  30. <div class="col-xs-12 col-sm-8">
  31. <select id="c-politics" data-rule="required" class="form-control selectpicker" name="row[politics]">
  32. {foreach name="politicsList" item="vo"}
  33. <option value="{$key}" {in name="key" value=""}selected{/in}>{$vo}</option>
  34. {/foreach}
  35. </select>
  36. </div>
  37. </div>
  38. <div class="form-group">
  39. <label class="control-label col-xs-12 col-sm-2">{:__('Birthday')}:</label>
  40. <div class="col-xs-12 col-sm-8">
  41. <input id="c-birthday" data-rule="required" class="form-control datetimepicker" data-date-format="YYYY-MM-DD" data-use-current="true" name="row[birthday]" type="text" value="{:date('Y-m-d')}">
  42. </div>
  43. </div>
  44. <div class="form-group">
  45. <label class="control-label col-xs-12 col-sm-2">{:__('Address')}:</label>
  46. <div class="col-xs-12 col-sm-8">
  47. <input id="c-address" data-rule="required" class="form-control" name="row[address]" type="text">
  48. </div>
  49. </div>
  50. <div class="form-group">
  51. <label class="control-label col-xs-12 col-sm-2">{:__('Company')}:</label>
  52. <div class="col-xs-12 col-sm-8">
  53. <input id="c-company" data-rule="required" class="form-control" name="row[company]" type="text">
  54. </div>
  55. </div>
  56. <div class="form-group">
  57. <label class="control-label col-xs-12 col-sm-2">{:__('Unit_nature')}:</label>
  58. <div class="col-xs-12 col-sm-8">
  59. <input id="c-unit_nature" data-rule="required" class="form-control" name="row[unit_nature]" type="text">
  60. </div>
  61. </div>
  62. <div class="form-group">
  63. <label class="control-label col-xs-12 col-sm-2">{:__('Monthly_income')}:</label>
  64. <div class="col-xs-12 col-sm-8">
  65. <input id="c-monthly_income" data-rule="required" class="form-control" step="0.01" name="row[monthly_income]" type="number">
  66. </div>
  67. </div>
  68. <div class="form-group">
  69. <label class="control-label col-xs-12 col-sm-2">{:__('Annual_household_income')}:</label>
  70. <div class="col-xs-12 col-sm-8">
  71. <input id="c-annual_household_income" data-rule="required" class="form-control" step="0.01" name="row[annual_household_income]" type="number">
  72. </div>
  73. </div>
  74. <div class="form-group">
  75. <label class="control-label col-xs-12 col-sm-2">{:__('Annual_household_income_average')}:</label>
  76. <div class="col-xs-12 col-sm-8">
  77. <input id="c-annual_household_income_average" data-rule="required" class="form-control" step="0.01" name="row[annual_household_income_average]" type="number">
  78. </div>
  79. </div>
  80. <div class="form-group">
  81. <label class="control-label col-xs-12 col-sm-2">{:__('Identity')}:</label>
  82. <div class="col-xs-12 col-sm-8">
  83. <input id="c-identity" data-rule="required" class="form-control" name="row[identity]" type="text">
  84. </div>
  85. </div>
  86. <div class="form-group">
  87. <label class="control-label col-xs-12 col-sm-2">{:__('Marriage')}:</label>
  88. <div class="col-xs-12 col-sm-8">
  89. <select id="c-marriage" data-rule="required" class="form-control selectpicker" name="row[marriage]">
  90. {foreach name="marriageList" item="vo"}
  91. <option value="{$key}" {in name="key" value="0"}selected{/in}>{$vo}</option>
  92. {/foreach}
  93. </select>
  94. </div>
  95. </div>
  96. <div class="form-group">
  97. <label class="control-label col-xs-12 col-sm-2">{:__('Medical_insurance')}:</label>
  98. <div class="col-xs-12 col-sm-8">
  99. <select id="c-medical_insurance" data-rule="required" class="form-control selectpicker" name="row[medical_insurance]">
  100. {foreach name="medicalInsuranceList" item="vo"}
  101. <option value="{$key}" {in name="key" value="0"}selected{/in}>{$vo}</option>
  102. {/foreach}
  103. </select>
  104. </div>
  105. </div>
  106. <div class="form-group">
  107. <label class="control-label col-xs-12 col-sm-2">{:__('Object_features')}:</label>
  108. <div class="col-xs-12 col-sm-8">
  109. <input id="c-object_features" data-rule="required" class="form-control" name="row[object_features]" type="text">
  110. </div>
  111. </div>
  112. <div class="form-group">
  113. <label class="control-label col-xs-12 col-sm-2">{:__('Reason')}:</label>
  114. <div class="col-xs-12 col-sm-8">
  115. <input id="c-reason" data-rule="required" class="form-control" name="row[reason]" type="text">
  116. </div>
  117. </div>
  118. <div class="form-group layer-footer">
  119. <label class="control-label col-xs-12 col-sm-2"></label>
  120. <div class="col-xs-12 col-sm-8">
  121. <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
  122. <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
  123. </div>
  124. </div>
  125. </form>