guochanhua/zskk_new_manage/application/admin/view/institution/contact/add.html

<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Hospital_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-hospital_id" data-rule="required"  class="form-control" name="row[hospital_id]" type="text" value="">
        </div>
    </div>
    <input id="c-hospital_name" type="hidden" name="row[hospital_name]">
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Super_hospital_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-super_hospital_id" data-rule="required" class="form-control" name="row[super_hospital_id]" type="text" value="">
        </div>
    </div>
    <input id="c-super_hospital_name" type="hidden" name="row[super_hospital_name]">
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Remote_doctor')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-remote_doctor" class="form-control" name="row[remote_doctor]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Pay_type')}:</label>
        <div class="col-xs-12 col-sm-8">
            {:build_radios('row[pay_type]', [ '1'=>'医院挂账', '0'=>'患者支付'], 0)}
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Status')}:</label>
        <div class="col-xs-12 col-sm-8">
            {:build_radios('row[status]', ['1'=>'正常&emsp;&emsp;', '0'=>'禁用&emsp;&emsp;'])}
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Sort')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-sort" data-rule="required" class="form-control" name="row[sort]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Remark')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-remark" class="form-control " rows="5" name="row[remark]" cols="50"></textarea>
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>