zhengbingbing
/
GXQGWH_UI


			
				
					
						
						
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							<!DOCTYPE html>
<html>

<head>
    <meta charset="UTF-8">
    <meta name="viewport" content="width=device-width, initial-scale=1.0">
    <script src="../../Script/Common/huayi.load.js"></script>
    <script src="../../Script/Common/huayi.config.js"></script>
    <link rel="stylesheet" href="../../css/WorkOrder/jquery.editable-select.css" />
    <link rel="stylesheet" href="../../js/comboSelect/combo.select.css" />
    <link rel="stylesheet" href="../../css/init.css" />
    <link rel="stylesheet" href="./css/registrationList.css">
    <title>编辑</title>
    <style>
        ul li {
            float: initial;
            list-style: none;
        }
        .wrapper-content{
            padding-right: 60px;
        }
        .common {
            width: 100%;
            text-align: center;
            padding: 10px 15px;
        }
        .common table {
            width: 100%;
        }
        .common table th {
            padding: 5px 8px 5px 0;
            text-align: right;
        }
	    .common table td {
            padding: 6px 0 5px 10px;
            text-align: left;
            color: #717171;
            line-height: 200%;
        }
        .common table td textarea {
            width: 100%;
            vertical-align: middle;
            resize: none;
            outline: none;
        }
        .form-group {
            margin-bottom: 0;
        }
		#formRegistrationType {
            display: inline-block;
            text-align: left;
            width: 80%;
            padding-left: 18px;
        }
        #formRegistrationType input[type="radio"] {
            margin-top: 3px
        } 
        .formRegistrationTypeText{
            text-align: right;
            padding-right: 0;
            margin-left: 15px;
        }
    </style>
</head>

<body class="gray-bg">
    <div class="clearfix wrapper wrapper-content animated fadeInRight">
        <div class="common">
            <div class="form-group col-md-12 clearfix">
                <label class="col-md-2 formRegistrationTypeText">登记类型：</label>
                <div id="formRegistrationType" class="col-md-6 r_order_type">
                    <label class="radio-inline">
                        <input type="radio" name="type" value="1" checked="checked" >咨询
                     </label>
                    <label class="radio-inline">
                       <input type="radio" name="type" value="2" >投诉
                    </label>
                    <label class="radio-inline">
                       <input type="radio" name="type" value="3" >求助
                    </label>
                    <label class="radio-inline">
                        <input type="radio" name="type" value="4" >其他
                     </label>
                </div>
            </div>
            <table class="customerService">
            	<tbody>
                    <tr>
                        <th>姓名：</th>
                        <td>
                            <div class="form-group">
                                <input type="text" class="form-control" id="formName" disabled="disabled" />
                            </div>
                        </td>
                        <th>电话：</th>
                        <td>
                            <div class="form-group">
                                <input type="text" class="form-control" id="formTel" disabled="disabled" />
                            </div>
                        </td>
                        <th>性别：</th>
                        <td>
                            <div class="form-group">
                                <select class="form-control" id="formSex" disabled="disabled">
                                    <option value="男">男</option>
                                    <option value="女">女</option>
                                </select>
                            </div>
                        </td>
                    </tr>
                    <tr>
                        <th>省：</th>
                        <td>
                            <div class="form-group">
                                <select class="form-control" id="formProvince" disabled="disabled">
                                    <option value="">请选择省</option>
                                </select>
                            </div>
                        </td>
                        <th>市：</th>
                        <td>
                            <div class="form-group">
                                <select class="form-control" id="formCity" disabled="disabled">
                                    <option value="">请选择市</option>
                                </select>
                            </div>
                        </td>
                        <th>县/区：</th>
                        <td>
                            <div class="form-group">
                                <select class="form-control" id="formCounty" disabled="disabled">
                                    <option value="">请选择县/区</option>
                                </select>
                            </div>
                        </td>
                    </tr>
                    <tr>
                        <th>详细地址</th>
                        <td>
                            <div class="form-group">
                                <input type="text" class="form-control" id="formAddress" disabled="disabled" />
                            </div>
                        </td>
                    </tr>
                    <tr>
                        <th>被投诉单位：</th>
                        <td>
                            <div class="form-group">
                                <input type="text" class="form-control" id="formComplainedUnit" />
                            </div>
                        </td>
                    </tr>
                    <tr>
                        <th>登记内容/投诉事项：</th>
                        <td colspan="7">
                            <textarea name="" rows="4" cols="" id="formRegistrationContent" style="margin-top:10px;"></textarea>
                        </td>
                    </tr>
                    <tr>
                        <th>备注：</th>
                        <td colspan="7">
                            <textarea name="" rows="4" cols="" id="formRegistrationRemark" style="margin-top:10px;"></textarea>
                        </td>
                    </tr>
                    <tr>
                        <td colspan="8" style="text-align: center;">
                            <button class="btns customerSubmit">保&nbsp;存</button>
                        </td>
                    </tr>
                </tbody>
            </table>
        </div>
    </div>

    <script src="../js/bootstrap-select/js/bootstrap-select.js"></script>
    <script src="../js/WorkOrder/jquery.editable-select.js"></script>
    <script src="../js/comboSelect/jquery.combo.select.js"></script>
    <script src="../js/laydate/laydate.js"></script>
    <script src="./js/edit.js"></script>
</body>

</html>