|
|
@ -26,46 +26,46 @@
|
|
|
<!-- </div> -->
|
|
|
<div class="m-form-group m-form-readonly" style="padding:10 0 10 0">
|
|
|
<label class="label_title" style="width:120px">编码</label>
|
|
|
<div class="l-text-wrapper m-form-control essential">
|
|
|
<input type="text" id="inp_patient_code" class="required useTitle ajax f-w240 validate-special-char" required-title="" data-attr-scan="code"/>
|
|
|
<div class="l-text-wrapper m-form-control ">
|
|
|
<input type="text" id="inp_patient_code" class="required useTitle ajax f-w240 validate-special-char" data-attr-scan="code"/>
|
|
|
</div>
|
|
|
</div>
|
|
|
<div class="m-form-group">
|
|
|
<label class="label_title" style="width:120px">姓名</label>
|
|
|
<div class="l-text-wrapper m-form-control essential">
|
|
|
<input type="text" id="inp_patient_name" class="required useTitle f-w240 validate-special-char" required-title="姓名不能为空" data-attr-scan="name"/>
|
|
|
<div class="l-text-wrapper m-form-control ">
|
|
|
<input type="text" id="inp_patient_name" class="f-w240 validate-special-char" data-attr-scan="name"/>
|
|
|
</div>
|
|
|
</div>
|
|
|
<div class="m-form-group">
|
|
|
<label class="label_title" style="width:120px">性别</label>
|
|
|
<div class="l-text-wrapper m-form-control essential">
|
|
|
<input type="text" id="sel_sex" data_type='select' class="required useTitle f-w240 validate-special-char" required-title="性别不能为空" data-attr-scan="sex"/>
|
|
|
<div class="l-text-wrapper m-form-control ">
|
|
|
<input type="text" id="sel_sex" data_type='select' class=" f-w240 validate-special-char" data-attr-scan="sex"/>
|
|
|
</div>
|
|
|
</div>
|
|
|
<div class="m-form-group hosp_dept">
|
|
|
<label class="label_title" style="width:120px">出生日期</label>
|
|
|
<div class="l-text-wrapper m-form-control essential" enabledEdit="false">
|
|
|
<input type="text" id="sel_birthday" data_type='select' class="required useTitle f-w240 validate-special-char" required-title="出生日期不能为空" data-attr-scan="birthday"/>
|
|
|
<div class="l-text-wrapper m-form-control " enabledEdit="false">
|
|
|
<input type="text" id="sel_birthday" data_type='select' class=" f-w240 validate-special-char" data-attr-scan="birthday"/>
|
|
|
</div>
|
|
|
</div>
|
|
|
<div class="m-form-group">
|
|
|
<label class="label_title" style="width:120px">身份证号</label>
|
|
|
<div class="l-text-wrapper m-form-control essential">
|
|
|
<input type="text" id="inp_idcard" class="required useTitle ajax f-w240 validate-id-number validate-special-char" validate-id-number-title="请输入合法的身份证号" required-title="身份证号不能为空" data-attr-scan="idcard"/>
|
|
|
<div class="l-text-wrapper m-form-control ">
|
|
|
<input type="text" id="inp_idcard" class=" ajax f-w240 validate-id-number validate-special-char" validate-id-number-title="请输入合法的身份证号" data-attr-scan="idcard"/>
|
|
|
</div>
|
|
|
</div>
|
|
|
|
|
|
<div class="m-form-group">
|
|
|
<label class="label_title" style="width:120px">社保卡号</label>
|
|
|
<div class="l-text-wrapper m-form-control essential">
|
|
|
<input type="text" id="inp_ssc" class="required useTitle ajax f-w240 validate-special-char" required-title="社保卡号不能为空" data-attr-scan="ssc"/>
|
|
|
<div class="l-text-wrapper m-form-control ">
|
|
|
<input type="text" id="inp_ssc" class=" ajax f-w240 validate-special-char" data-attr-scan="ssc"/>
|
|
|
</div>
|
|
|
</div>
|
|
|
|
|
|
<div class="m-form-group">
|
|
|
<label class="label_title" style="width:120px">医疗保险号</label>
|
|
|
<div class="l-text-wrapper m-form-control essential">
|
|
|
<input type="text" id="inp_medicareNumber" class="required useTitle ajax f-w240 validate-special-char" required-title="医疗保险号不能为空" data-attr-scan="medicareNumber"/>
|
|
|
<div class="l-text-wrapper m-form-control ">
|
|
|
<input type="text" id="inp_medicareNumber" class=" ajax f-w240 validate-special-char" required-title="医疗保险号不能为空" data-attr-scan="medicareNumber"/>
|
|
|
</div>
|
|
|
</div>
|
|
|
|
humingfen