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@@ -1,4 +1,277 @@
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+<link rel="stylesheet" href="/thmz/css/bootstrap/css/bootstrap-select.css"/>
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+<script src="/thmz/js/bootstrap-select.js"></script>
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+<script src="/thmz/js/registration.js"></script>
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+<style>
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+ .title {
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+ font-size: 16px !important;
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+ margin-bottom: 20px !important;
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+ margin-left: 20px !important;
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+ margin-top: 20px !important;
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+ }
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+
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+ #clearRegistration {
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+ cursor: pointer;
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+ color: #337AB7 !important;
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+ font-size: 14px;
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+ }
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+
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+ .total {
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+ float: left;
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+ padding-right: 10px;
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+ margin-left: 14px;
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+ font-weight: 700;
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+ font-size: 20px;
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+ }
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+
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+ .total span {
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+ color: #337AB7 !important;
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+ }
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+
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+ #regi_form {
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+ border-right: 1px solid #DCDCDC;
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+ }
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+
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+ #confirmFee {
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+ width: 100%;
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+ height: 40px;
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+ margin-left: 14px;
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+ margin-right: 10px;
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+ }
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+</style>
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<div class="row">
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- <div class="col-md-4 col-sm-4 col-xs-12"></div>
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- <div class="col-md-8 col-sm-8 col-xs-12"></div>
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-</div>
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+ <div class="col-md-4 col-sm-4 col-xs-12">
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+ <div class="title">
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+ <div>新增挂号</div>
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+ </div>
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+ <form class="form-horizontal form-label-left mz-fixed-form" novalidate id="regi_form">
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+ <div class="item form-group">
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+ <div class="col-md-6 col-sm-6 col-xs-12">
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+ <button type="button" style="margin-left:14px;cursor: none;margin-bottom: 10px !important;"
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+ class="btn btn-primary">
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+ 基本信息
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+ </button>
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+ </div>
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+ <div class="col-md-6 col-sm-6 col-xs-12">
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+ <a id="clearRegistration"><i class="fa fa-trash"
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+ style="margin-right: 10px;float: right;"> 清空</i></a>
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+ </div>
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+ </div>
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+ <div class="item form-group">
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+ <div class="col-md-6 col-sm-6 col-xs-12">
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+ <label class="control-label col-md-4 col-sm-4 col-xs-12" for="userName">姓名 <span
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+ class="required">*</span>
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+ </label>
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+ <div class="col-md-8 col-sm-8 col-xs-12">
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+ <input id="userName" class="form-control col-md-7 col-xs-12" data-validate-length-range="2,10"
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+ placeholder="姓名/卡号/手机号" required="required" type="text">
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+ </div>
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+ </div>
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+ <div class="col-md-6 col-sm-6 col-xs-12">
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+ <label class="control-label col-md-4 col-sm-4 col-xs-12" for="age">年龄 <span
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+ class="required">*</span>
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+ </label>
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+ <div class="col-md-8 col-sm-8 col-xs-12">
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+ <div class="input-group">
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+ <input id="age" class="form-control" data-validate-length-range="2,10"
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+ placeholder="请输入" required="required" type="Number">
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+ <div class="input-group-btn">
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+ <button type="button" class="btn btn-default dropdown-toggle" data-toggle="dropdown"
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+ aria-expanded="false" style="margin-right: 0px;">岁 <span class="caret"></span>
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+ </button>
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+ <ul class="dropdown-menu dropdown-menu-right" role="menu"
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+ style="width: 50px;min-width: 50px;">
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+ <li><a href="#">岁</a>
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+ </li>
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+ <li><a href="#">月</a>
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+ </li>
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+ <li><a href="#">天</a>
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+ </li>
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+ </ul>
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+ </div>
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+ <!-- /btn-group -->
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+ </div>
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+ </div>
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+ </div>
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+ </div>
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+ <div class="item form-group">
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+ <div class="col-md-6 col-sm-6 col-xs-12">
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+ <label class="control-label col-md-4 col-sm-4 col-xs-12" for="gender">性别 <span
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+ class="required">*</span>
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+ </label>
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+ <div class="col-md-8 col-sm-8 col-xs-12">
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+ <select class="form-control selectpicker show-tick" required="required" id="gender">
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+ </select>
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+ </div>
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+ </div>
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+ <div class="col-md-6 col-sm-6 col-xs-12">
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+ <label class="control-label col-md-4 col-sm-4 col-xs-12" for="birthDay">出生日期 <span
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+ class="required">*</span>
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+ </label>
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+ <div class="col-md-8 col-sm-8 col-xs-12">
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+ <div class='input-group date' id='birthDay'>
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+ <input type='text' class="form-control"/>
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+ <span class="input-group-addon">
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+ <span class="glyphicon glyphicon-calendar"></span>
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+ </span>
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+ </div>
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+ </div>
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+ </div>
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+ </div>
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+ <div class="item form-group">
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+ <div class="col-md-6 col-sm-6 col-xs-12">
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+ <label class="control-label col-md-4 col-sm-4 col-xs-12" for="cardNo">卡号 <span
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+ class="required">*</span>
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+ </label>
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+ <div class="col-md-8 col-sm-8 col-xs-12">
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+ <div class="input-group demo2">
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+ <input id="cardNo" class="form-control col-md-7 col-xs-12" data-validate-length-range="2,10"
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+ placeholder="请输入" required="required" type="text">
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+ <span class="input-group-addon"><a href="#"><i class="fa fa-credit-card"></i></a></span>
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+ </div>
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+
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+ </div>
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+ </div>
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+ <div class="col-md-6 col-sm-6 col-xs-12">
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+ <label class="control-label col-md-4 col-sm-4 col-xs-12" for="phoneNum">手机号码 <span
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+ class="required">*</span>
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+ </label>
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+ <div class="col-md-8 col-sm-8 col-xs-12">
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+ <input id="phoneNum" class="form-control col-md-7 col-xs-12" data-validate-length-range="2,10"
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+ placeholder="请输入" required="required" type="text">
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+ </div>
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+ </div>
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+ </div>
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+ <div class="item form-group">
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+ <div class="col-md-6 col-sm-6 col-xs-12">
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+ <label class="control-label col-md-4 col-sm-4 col-xs-12" for="patientsNature">病人性质 <span
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+ class="required">*</span>
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+ </label>
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+ <div class="col-md-8 col-sm-8 col-xs-12">
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+ <select class="form-control selectpicker show-tick" required="required" id="patientsNature">
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+ </select>
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+ </div>
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+ </div>
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+ <div class="col-md-6 col-sm-6 col-xs-12">
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+ <label class="control-label col-md-4 col-sm-4 col-xs-12" for="idCard">身份证 <span
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+ class="required">*</span>
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+ </label>
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+ <div class="col-md-8 col-sm-8 col-xs-12">
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+ <div class="input-group demo2">
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+ <input id="idCard" class="form-control col-md-7 col-xs-12" data-validate-length-range="2,10"
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+ placeholder="请输入" required="required" type="text">
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+ <span class="input-group-addon"><a href="#"><i class="fa fa-newspaper-o"></i></a></span>
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+ </div>
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+ </div>
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+ </div>
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+ </div>
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+
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+ <div class="item form-group">
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+ <div class="col-md-6 col-sm-6 col-xs-12">
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+ <label class="control-label col-md-4 col-sm-4 col-xs-12" for="address">地址 <span
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+ class="required">*</span>
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+ </label>
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+ <div class="col-md-8 col-sm-8 col-xs-12">
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+ <input id="address" class="form-control col-md-7 col-xs-12" data-validate-length-range="2,10"
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+ placeholder="请输入" required="required" type="text">
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+ </div>
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+ </div>
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+ <div class="col-md-6 col-sm-6 col-xs-12">
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+ <label class="control-label col-md-4 col-sm-4 col-xs-12" for="remark">备注 <span
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+ class="required">*</span>
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+ </label>
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+ <div class="col-md-8 col-sm-8 col-xs-12">
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+ <input id="remark" class="form-control col-md-7 col-xs-12" data-validate-length-range="2,10"
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+ placeholder="请输入" required="required" type="text">
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+ </div>
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+ </div>
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+ </div>
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+ <div class="item form-group">
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+ <div class="col-md-6 col-sm-6 col-xs-12">
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+ <button type="button" style="margin-left:14px;cursor: none;margin-bottom: 10px !important;"
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+ class="btn btn-primary">
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+ 科室信息
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+ </button>
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+ </div>
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+ </div>
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+ <div class="item form-group">
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+ <div class="col-md-6 col-sm-6 col-xs-12">
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+ <label class="control-label col-md-4 col-sm-4 col-xs-12" for="deptNo">科室 <span
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+ class="required">*</span>
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+ </label>
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+ <div class="col-md-8 col-sm-8 col-xs-12">
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+ <select class="form-control selectpicker show-tick" data-live-search="true" required="required"
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+ id="deptNo">
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+ </select>
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+ </div>
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+ </div>
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+ <div class="col-md-6 col-sm-6 col-xs-12">
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+ <label class="control-label col-md-4 col-sm-4 col-xs-12" for="doctor">医生 <span
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+ class="required">*</span>
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+ </label>
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+ <div class="col-md-8 col-sm-8 col-xs-12">
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+ <select class="form-control selectpicker show-tick" data-live-search="true" required="required"
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+ id="doctor">
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+ </select>
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+ </div>
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+ </div>
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+ </div>
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+ <div class="item form-group">
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+ <div class="col-md-6 col-sm-6 col-xs-12">
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+ <button type="button" style="margin-left:14px;cursor: none;margin-bottom: 10px !important;"
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+ class="btn btn-primary">
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+ 收费信息
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+ </button>
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+ </div>
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+ </div>
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+ <div class="item form-group">
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+ <div class="col-md-6 col-sm-6 col-xs-12">
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+ <label class="control-label col-md-4 col-sm-4 col-xs-12" for="registrationFee">挂号费 <span
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+ class="required">*</span>
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+ </label>
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+ <div class="col-md-8 col-sm-8 col-xs-12">
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+ <input id="registrationFee" class="form-control col-md-7 col-xs-12"
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+ data-validate-length-range="2,10"
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+ placeholder="请输入" required="required" type="Number">
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+ </div>
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+ </div>
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+ <div class="col-md-6 col-sm-6 col-xs-12">
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+ <label class="control-label col-md-4 col-sm-4 col-xs-12" for="hospitalFee">诊金 <span
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+ class="required">*</span>
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+ </label>
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+ <div class="col-md-8 col-sm-8 col-xs-12">
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+ <input id="hospitalFee" class="form-control col-md-7 col-xs-12"
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+ data-validate-length-range="2,10"
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+ placeholder="请输入" required="required" type="Number">
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+ </div>
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+ </div>
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+ </div>
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+
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+
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+ <div class="item form-group" style="margin-top: 50px;">
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+ <div class="col-md-6 col-sm-6 col-xs-12">
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+ <div class="total"> 合计:
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+ <span class="amountMoney">15.54元</span>
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+ </div>
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+ </div>
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+ <div class="col-md-6 col-sm-6 col-xs-12">
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+ <button type="button" class="btn btn-primary" style="margin-right: 10px;float: right;">
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+ <span>附加费</span>
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+ </button>
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+ </div>
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+ </div>
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+
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+ <div class="item form-group" style="margin-top: 20px;">
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+ <div class="col-md-12 col-sm-12 col-xs-12">
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+ <button type="button" class="btn btn-primary" id="confirmFee">
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+ <span>确认收费</span>
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+ </button>
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+ </div>
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+ </div>
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+ </form>
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+ </div>
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+ <div class="col-md-8 col-sm-8 col-xs-12">
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+ <div class="title">
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+ <div>挂号列表</div>
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+ </div>
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+ </div>
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+</div>
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