zhengbingbing
/
XiXianDC_UI


			
				
					
						
						
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							<!DOCTYPE html>
<html lang="zh-CN" class="feedback">

	<head>
		<meta charset="UTF-8" />
		<meta name="viewport" content="width=device-width,initial-scale=1,minimum-scale=1,maximum-scale=1,user-scalable=no" />
		<meta http-equiv="X-UA-Compatible" content="ie=edge" />
		<meta name="apple-mobile-web-app-capable" content="yes">
		<meta name="apple-mobile-web-app-status-bar-style" content="black">
		<title>问卷调查</title>
		<link rel="stylesheet" type="text/css" href="../css/mui.min.css" />
		<link rel="stylesheet" type="text/css" href="../css/feedback-page.css" />
		<link rel="stylesheet" type="text/css" href="../css/mui.picker.min.css" />
		<link rel="stylesheet" type="text/css" href="../css/Common.css?v=0619" />
	</head>

	<body class="questionnaire">
		<div class="hy_loading" id="hy_loading">
			<img class="loading_img" src="../images/loading-0.gif" alt="加载中" />
		</div>
		<header>
			<h4 class="que_header_title" id="que_header_title"></h4>
			<p class="que_header_content" id="que_header_content"></p>
		</header>
		<div class="mui-card">
			<div class="mui-card-header">个人信息</div>
			<form class="mui-input-group">
				<div class="mui-input-row">
					<label for="h_userName">姓名：</label>
					<input type="text" class="mui-input-clear" id="h_userName" placeholder="请输入姓名">
				</div>
				<div class="mui-input-row">
					<label for="h_telphone">手机：</label>
					<input type="text" class="mui-input-clear" id="h_telphone" placeholder="请输入手机号码">
				</div>
				<div class="mui-input-row">
					<label for="h_phone">固话：</label>
					<input type="text" class="mui-input-clear" id="h_phone" placeholder="请输入固定电话号码">
				</div>
				<div id="showCountyPicker">
					<div class="mui-input-row">
						<label class="label" for="h_county">乡镇：</label>
						<input type="text" id="h_county" class="ui-alert type_con" placeholder="请选择乡镇" data-index="0">
						<a><span class="type_down mui-icon mui-icon-arrowdown mui-pull-right"></span></a>
					</div>
				</div>
				<div class="mui-input-row">
					<label for="h_address">地址：</label>
					<input type="text" class="mui-input-clear" id="h_address" placeholder="请输入地址">
				</div>
			</form>
		</div>
		<div class="mui-card">
			<div class="mui-card-header">问卷信息</div>
		</div>
		<div id="questionBody">

		</div>
		<div class="mui-button-row" id="Btns-box">
			<button type="button" id="submit" data-loading-text="提交中" class="mui-btn mui-btn-primary" onclick="return false;">提交</button>
		</div>
		</div>
		<script src="../js/zepto.js"></script>
		<script src="../js/mui.min.js"></script>
		<script src="../js/mui.picker.min.js"></script>
		<script src="../js/mui.poppicker.js"></script>
		<script src="../Script/Common/huayi.config.js"></script>
		<script src="../Script/Common/huayi.http.js"></script>
		<script src="../js/questionnarire.js"></script>
	</body>

</html>