xinxicaiji.html 8.3 KB

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  1. <!DOCTYPE html>
  2. <html>
  3. <head>
  4. <meta charset="UTF-8">
  5. <title>详细信息采集</title>
  6. <meta name="author" content="yihu.com" />
  7. <meta name="viewport" content="width=device-width, initial-scale=1.0, minimum-scale=1.0, maximum-scale=1.0, user-scalable=0" />
  8. <meta name="apple-mobile-web-app-capable" content="yes" />
  9. <meta name="apple-mobile-web-app-status-bar-style" content="black" />
  10. <link rel="stylesheet" type="text/css" href="../../../css/mui.min.css">
  11. <link rel="stylesheet" type="text/css" href="../../../common/cross/css/cross.css">
  12. <link rel="stylesheet" href="../../../common/cross/css/cross.ui.css">
  13. <link rel="stylesheet" type="text/css" href="../css/xinxicaiji.css" />
  14. </head>
  15. <body>
  16. <div class="h45">
  17. <div class="demo-comtop">
  18. <a class="mui-action-back"></a>
  19. <h1>详细信息采集</h1>
  20. </div>
  21. </div>
  22. <div class="c-main">
  23. </div>
  24. <script type="text/html" id="list_tmp">
  25. <ul class="xc-ul">
  26. <li class="xc-li" id="school" data-code="" data-name="">
  27. <div class="key">文化程度</div>
  28. <div class="info">
  29. <select name="" id="schoolSel" class="c-hide"></select>
  30. <span class="dl-input-icon"></span>
  31. </div>
  32. </li>
  33. <li class="xc-li" id="job" data-code="" data-name="">
  34. <div class="key">职业</div>
  35. <div class="info">
  36. <select name="" id="jobSel" class="c-hide"></select>
  37. <span class="dl-input-icon"></span>
  38. </div>
  39. </li>
  40. <li class="xc-li long" id="pay" data-code="" data-name="">
  41. <div class="key">医疗费用支付方式</div>
  42. <div class="info">
  43. <select name="" id="paySel" class="c-hide"></select>
  44. <span class="dl-input-icon"></span>
  45. </div>
  46. </li>
  47. <li class="xc-li long" id="disability" data-code="" data-name="">
  48. <div class="key">残疾情况</div>
  49. <div class="info">
  50. <select name="" id="disabilitySel" class="c-hide"></select>
  51. <span class="dl-input-icon"></span>
  52. </div>
  53. </li>
  54. <li class="xc-li-more j-drug">
  55. <div class="xc-radio">
  56. <div class="name">药物过敏史</div>
  57. <div class="one" data-id="0">
  58. <div></div>
  59. <div>无</div>
  60. </div>
  61. <div class="one" data-id="1">
  62. <div></div>
  63. <div>有</div>
  64. </div>
  65. </div>
  66. <div class="xc-li-radio c-hide">
  67. {{each data.allergy as val}}
  68. {{if val.code !=4}}
  69. <div class="child j-noOther" data-code="{{val.code}}" data-name="{{val.value}}">
  70. <div class="j-checkbox"></div>
  71. <div class="j-checkbox">{{val.value}}</div>
  72. </div>
  73. {{else}}
  74. <div class="child j-drug-other">
  75. <div class="j-showbox"></div>
  76. <div class="j-showbox w80">其他</div>
  77. <input class="other c-hide j-hide" type="text" placeholder="请输入药品名称" maxlength="30"/>
  78. </div>
  79. {{/if}}
  80. {{/each}}
  81. </div>
  82. </li>
  83. <li class="xc-li-more j-past" >
  84. <div class="xc-radio">
  85. <div class="name">既往史</div>
  86. <div class="one" data-id="0">
  87. <div></div>
  88. <div>无</div>
  89. </div>
  90. <div class="one" data-id="1">
  91. <div></div>
  92. <div>有</div>
  93. </div>
  94. </div>
  95. <div class="xc-li-radio c-hide">
  96. {{each data.pastHistory as it}}
  97. {{if it.code !=4}}
  98. <div class="child j-noOther" data-code="{{it.code}}" data-name="{{it.value}}">
  99. <div class="j-showbox"></div>
  100. <div class="j-showbox w80">{{it.value}}</div>
  101. <input class="other c-hide dateSel j-hide" type="text" placeholder="请输入确诊时间"/>
  102. </div>
  103. {{else}}
  104. <div class="child j-past-other">
  105. <div class="j-showbox"></div>
  106. <div class="j-showbox w80">其他</div>
  107. <input class="other past c-hide j-hide" type="text" placeholder="请输入疾病名称" maxlength="30"/>
  108. </div>
  109. {{/if}}
  110. {{/each}}
  111. </div>
  112. </li>
  113. <li class="xc-li-more j-gen" >
  114. <div class="xc-radio">
  115. <div class="name">遗传病史</div>
  116. <div class="one" data-id="0">
  117. <div></div>
  118. <div>无</div>
  119. </div>
  120. <div class="one" data-id="1">
  121. <div></div>
  122. <div>有</div>
  123. </div>
  124. </div>
  125. <div class="xc-li-radio c-hide">
  126. <div class="child longer">
  127. <input class="other" type="text" placeholder="请输入疾病名称" maxlength="30"/>
  128. </div>
  129. </div>
  130. </li>
  131. <li class="xc-li-more j-family" >
  132. <div class="xc-radio">
  133. <div class="name">家族史</div>
  134. <div class="one" data-id="0">
  135. <div></div>
  136. <div>无</div>
  137. </div>
  138. <div class="one" data-id="1">
  139. <div></div>
  140. <div>有</div>
  141. </div>
  142. </div>
  143. <div class="xc-li-radio small c-hide">
  144. <div class="child2 j-sel">
  145. <div>父亲疾病类型</div>
  146. <div class="info">
  147. <select class="sickSel c-hide" multiple data-code="" data-name=""></select>
  148. </div>
  149. </div>
  150. <div class="child2 j-sel">
  151. <div>母亲疾病类型</div>
  152. <div class="info">
  153. <select class="sickSel c-hide" multiple data-code="" data-name=""></select>
  154. </div>
  155. </div>
  156. <div class="child2 j-sel">
  157. <div>兄弟姐妹疾病类型</div>
  158. <div class="info">
  159. <select class="sickSel c-hide" multiple data-code="" data-name=""></select>
  160. </div>
  161. </div>
  162. <div class="child2 j-sel">
  163. <div>子女疾病类型</div>
  164. <div class="info">
  165. <select class="sickSel c-hide" multiple data-code="" data-name=""></select>
  166. </div>
  167. </div>
  168. </div>
  169. </li>
  170. </ul>
  171. <div class="jm-foot">
  172. <div class="jm-btn">提交</div>
  173. </div>
  174. </script>
  175. <script src="../../../js/jquery/2.1.3/jquery.js"></script>
  176. <script type="text/javascript" src="../../../js/mui.min.js"></script>
  177. <link rel="stylesheet" type="text/css" href="../../../widget/mobiscroll/2.17.1/css/mobiscroll.css"/>
  178. <script src="../../../widget/mobiscroll/2.17.1/js/mobiscroll.js" type="text/javascript" charset="utf-8"></script>
  179. <script src="../../../js/template.js"></script>
  180. <script src="../../../js/common_http.js" type="text/javascript" charset="utf-8"></script>
  181. <script src="../js/xinxicaiji.js" type="text/javascript" charset="utf-8"></script>
  182. </body>
  183. </html>