Amoy2
/
sr-iHealthApp


			
				
					
						
						
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							<!doctype html>
<html>

	<head>
		<meta charset="utf-8">
		<title>手工代签约</title>
		<meta name="author" content="yihu.com" />
		<meta name="format-detection" content="telephone=no" />
		<meta name="viewport" content="width=device-width, initial-scale=1.0, minimum-scale=1.0, maximum-scale=1.0, user-scalable=0" />
		<meta name="apple-mobile-web-app-capable" content="yes" />
		<meta name="apple-mobile-web-app-status-bar-style" content="black" />
		<link rel="stylesheet" type="text/css" href="../../../common/iconfont/iconfont.css">
		<link rel="stylesheet" type="text/css" href="../../../common/cross/css/cross.css">
		<link rel="stylesheet" href="../../../common/cross/css/cross.ui.css" type="text/css" />
		<link rel="stylesheet" type="text/css" href="../../../common/css/jy-style.css">
		<link rel="stylesheet" type="text/css" href="../../../common/css/doc-style.css" />
		<style>
			/*#doctor_zk{ display: none;}*/ 
			.no{ display: none; position: absolute;left:0;top:0px; width:100%; height: 100%;z-index:10}
			.jge{background: #f3f3f3;min-height:10px;margin-left: 0 !important;border-top: 1px solid #e1e1e1 !important;border-bottom: 1px #e1e1e1 solid; padding-left:15px; }
			.jge a{color: #17b3ec;}
			.tag_cyc{position: relative; width: 47px; display: inline-block; height: 30px; background-color: #fff; background-clip: padding-box; border: 2px solid #ddd; border-radius: 20px; }
			.tag_cyc i{position: absolute;top: 1px;left: -1px; z-index: 1;width: 28px;height: 28px; background-color: #fff; background-clip: padding-box; border-radius: 16px; -webkit-box-shadow: 0 2px 5px rgba(0,0,0,.4); box-shadow: 0 2px 5px rgba(0,0,0,.4); }
			.tag_cyc.on{ background-color: #4cd964; border-color: #4cd964}  
			.tag_cyc.on i{ left:auto;right: -1px; }
			#disease{ display: none;}
			/*#upload{display: block;width: 86px;height: 45px;position: absolute;right: 0;top: 0;color: #17b3ec;}*/
		</style>
	
	</head>

	<body>
		<div class="h45">
			<div class="demo-comtop">
				<a class="mui-action-back"></a>
				<h1 class="c-f17">手工代理签约</h1>
				<!--<a href="javascript:void(0);" id="upload">提交签约</a>-->
			</div>
		</div>
		<div class="c-main">
			
			<ul class="n-list edit-list c-border-tb mt10" id="info_list">
				<li class="n-list-cover" id="name">
					<div class="n-list-key w3em"><i class="required"></i>姓&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;名</div>
					<div class="n-list-info pl10">
						<input type="text" class="c-input width-100" placeholder="请输入居民姓名" />
					</div> 
				</li>
				<li class="n-list-cover" id="idcard">
					<div class="n-list-key w3em"><i class="required"></i>身份证号</div>
					<div class="n-list-info pl10">
						<input type="text" class="c-input width-100" placeholder="请输入身份证号" maxlength="18" />
					</div>
				</li> 
				<li class="n-list-cover" id="ssc">
					<div class="n-list-key w3em"><i class="required"></i>医保卡号</div>
					<div class="n-list-info pl10">
						<input type="text" class="c-input width-100" placeholder="请输入医保卡号" />
					</div>
				</li>
				<li class="n-list-cover" id="mobile">
					<div class="n-list-key w3em"><i class="required"></i>手机号码</div>
					<div class="n-list-info pl10">
						<input type="text" class="ajax c-input width-100" placeholder="请输入手机号码" maxlength="11" />
					</div>
				</li>
				<li class="jge"><a href="javascript:void(0);" style=" display: none;">信息有误？重新扫描</a></li>
				<li class="n-list-cover" id="emerMoblie">
					<div class="n-list-key w3em">联系人电话</div>
					<div class="n-list-info pl10">
						<input id='emerMoblieIpt' type="text" class="c-input width-100" placeholder="请输入应急人的手机号码" maxlength="11" />
					</div>
				</li>
				<li class="n-list-cover" id="li_group">
					<div class="n-list-key w3em">居民分组</div>
					<div class="n-list-info pl10">
						<input type="text"  readonly="readonly" class="c-input width-100"  data-val="li_group" placeholder="请输入居民分组" data-code="" />
					</div>
				</li>
				<li class="jge"></li>
				<li class="n-list-cover" >
					<div class="n-list-key w3em"><i></i>是否慢病</div>
					<div class="no"></div>
					<div class="n-list-info pl10" style="text-align: right;">
						<a href="javacript:void(0);" class="tag_cyc">
							<i></i>
						</a>
					</div>
				</li>
				<li class="n-list-cover" id="disease">
					<div class="n-list-key w3em"><i class="required"></i>慢病类别</div>
					<div class="no"></div>
					<div class="n-list-info pl10" style="text-align: right;">
						<div class="no"></div>
						<input type="text" placeholder="请选择慢病疾病类别" class="c-input width-100" readonly data-val="disease" />
					</div>
				</li>
				<li class="jge"></li>
				<li class="n-list-cover" id="dortor_qke">
					<div class="n-list-key w3em"><i class="required"></i>全科医生</div>
					<div class="n-list-info pl10">
						<input type="text" placeholder="请选择疾病类型" class="c-input width-100" readonly data-val="dortor_qke" data-code="0" value="请选择全科医生"/>
					</div>
					
				</li>
			  	<li class="n-list-cover" id="healthManagement">
					<div class="n-list-key w3em"><i class="required"></i>健康管理师</div>
					<div class="n-list-info pl10">
						<div class="no"></div>
						<input type="text" value="" placeholder="请选择健康管理师" class="c-input width-100" readonly data-val="healthManagement" />
					</div>
				</li>
				<li class="n-list-cover" id="doctor_zk">
					<div class="n-list-key w3em"><i class="required"></i>专科医生</div>				
					<div class="n-list-info pl10">
						<div class="no"></div>
						<input type="text" placeholder="请选择专科医生" class="width-100 c-boxs ptb15" readonly data-val="doctor_zk" />
					</div>
				</li>
				<li class="jge"></li>
				<li class="n-list-cover" id="li_expenses">
					<div class="n-list-key w3em">政府补贴费</div>				
					<div class="n-list-info pl10">
						<input type="text" placeholder="请选择补贴金额" class="width-100 c-boxs ptb15" readonly data-val="expenses" data-code="0" />
					</div>
				</li>
			
			</ul>

			<!--<div class="n-list bgc-fff c-border-tb  " id="div_qianyue">
				<div class="n-list-li">
					<div class="n-list-key width-30 required c-f14 c-5b5b5b">所在分组</div>
					<div class="n-list-info c-t-right">
						<input type="text" placeholder="请选择居民分组" class="width-100 c-boxs c-t-right ptb15" readonly data-val="group" />
					</div>
				</div>
			</div>-->
			<ul class="n-list edit-list-file c-border-tb mt10">
				<li class="ptb12 n-list-cover c-border-b">
					<div class="n-list-key">
						<!--<i class="required"></i>添加附件<span class="c-f12 c-909090">（请上传签约居民的身份证和医保卡照片）</span>-->
						添加附件<span class="c-f14 c-909090">（请上传签约居民的身份证和医保卡照片）</span>
					</div>
				</li>

				<li class="pt10 mb10">
					<div class="upload-img">
						<ul class="add-img pt10">
							<!--<li>
					<img src="../images/doctor.png" alt="图片" />
					<i class="icon-del"></i>
				</li>
				<li>
					<img src="../images/doctor.png" alt="图片" />
					<i class="icon-del"></i>
				</li>-->
							<li class="add">
							</li>
						</ul>
					</div>
				</li>
			</ul>

			<div class="plr10 mt10">
				<div class="input-group-checkbox">
					<!--<label>-->
					<div class="input-group-pack checked">
						<span class="tick"></span>
					</div>
					<!--</label>-->
					<a style="color: #37a6ec;font-size: 16px;" onclick="toXieYiShu()">家庭医生签约协议</a>
				</div>
			</div>
			<!--<div class="plr10 mt15 pb20" style="text-align: center;">
				<a class="c-btn c-btn-full c-btn-37a6ec border-radius-rounded c-fff"  id="upload" style="display: block;padding: 10px;">提 交</a>
			</div>-->
			<div class="plr10 mt15 pb20">
				<a class="c-btn c-btn-full c-btn-37a6ec border-radius-rounded" id="upload">提 交</a>
			</div>
		</div>

		<!-- 放置要缩放的图片的容器 -->
		<section class="imgzoom-pack"> 
			<div class="imgzoom-x">关闭</div>
			<div class="imgzoom-del"><i class="iconfont icon-laji"></i></div>
			<div class="imgzoom-img"><img src="" /></div>
		</section>
		<script src="../../../js/jquery/2.1.3/jquery.js"></script>
		<script type="text/javascript" src="../../../js/mui.min.js"></script>
		<link rel="stylesheet" type="text/css" href="../../../widget/artDialog/6.0.5/css/ui-dialog.min.css" />
		<script src="../../../widget/artDialog/6.0.5/js/dialog-plus.min.js" type="text/javascript" charset="utf-8"></script>
		<script src="../../../widget/mobiscroll/2.17.1/js/mobiscroll.js" type="text/javascript" charset="utf-8"></script>
		<link rel="stylesheet" type="text/css" href="../../../widget/mobiscroll/2.17.1/css/mobiscroll.css" />
		<script src="../../../widget/scale/scale.js" type="text/javascript" charset="utf-8"></script>
		<script src="../../../js/upload_preview.js" type="text/javascript" charset="utf-8"></script>
		<script src="../../../js/common_http.js" type="text/javascript" charset="utf-8"></script>
		<script src="../../../js/security.js" type="text/javascript" charset="utf-8"></script>
		<script src="../js/dailiqianyue.js" type="text/javascript" charset="utf-8"></script>
	</body>

</html>