<!DOCTYPE html> <html lang="en"> <head> <meta charset="utf-8"> <meta http-equiv="X-UA-Compatible" content="IE=edge"> <meta name="viewport" content="width=device-width, initial-scale=1"> <title>患者预约系统</title> <!-- CSS --> <link rel="stylesheet" href="http://fonts.googleapis.com/css?family=Roboto:400,100,300,500"> <link rel="stylesheet" href="__PUBLIC__/assets/bootstrap/css/bootstrap.min.css"> <link rel="stylesheet" href="__PUBLIC__/assets/font-awesome/css/font-awesome.min.css"> <link rel="stylesheet" href="__PUBLIC__/assets/css/form-elements.css"> <link rel="stylesheet" href="__PUBLIC__/assets/css/style.css"> <!-- HTML5 Shim and Respond.js IE8 support of HTML5 elements and media queries --> <!-- WARNING: Respond.js doesn't work if you view the page via file:// --> <!--[if lt IE 9]> <script src="https://oss.maxcdn.com/libs/html5shiv/3.7.0/html5shiv.js"></script> <script src="https://oss.maxcdn.com/libs/respond.js/1.4.2/respond.min.js"></script> <![endif]--> <!-- Favicon and touch icons --> <link rel="shortcut icon" href="__PUBLIC__/assets/ico/favicon.png"> <link rel="apple-touch-icon-precomposed" sizes="144x144" href="__PUBLIC__/assets/ico/apple-touch-icon-144-precomposed.png"> <link rel="apple-touch-icon-precomposed" sizes="114x114" href="__PUBLIC__/assets/ico/apple-touch-icon-114-precomposed.png"> <link rel="apple-touch-icon-precomposed" sizes="72x72" href="__PUBLIC__/assets/ico/apple-touch-icon-72-precomposed.png"> <link rel="apple-touch-icon-precomposed" href="__PUBLIC__/assets/ico/apple-touch-icon-57-precomposed.png"> <script> function sub(){ var ou=document.myForm.username; var op=document.myForm.password; if(ou.value==''||op.value=='' ){ alert('用户名、密码的值不能为空') }else{ document.myForm.submit(); } } </script> </head> <body> <!-- Top content --> <div class="top-content"> <div class="inner-bg"> <div class="container"> <div class="row"> <div class="col-sm-8 col-sm-offset-2 text"> <h1><strong>这里可以写</strong> 公司的名字</h1> <div class="description"> <p> <strong>欢迎使用!</strong> </p> </div> </div> </div> <div class="row"> <div class="col-sm-6 col-sm-offset-3 form-box"> <div class="form-top"> <div class="form-top-left"> <h3>患者预约系统</h3> <p>请在下方输入用户名和密码:</p> </div> <div class="form-top-right"> <i class="fa fa-key"></i> </div> </div> <div class="form-bottom"> <form role="form" action="__URL__/do_Login" method="post" class="login-form" name='myForm'> <div class="form-group"> <label class="sr-only" for="username">用户名</label> <input type="text" name="username" placeholder="用户名" class="form-username form-control" id="username"> </div> <div class="form-group"> <label class="sr-only" for="password">密码</label> <input type="password" name="password" placeholder="密码" class="form-password form-control" id="password"> </div> <button type="submit" class="btn" onclick="sub()">登 录</button> </form> </div> </div> </div> </div> </div> </div> <!-- Javascript --> <script src="__PUBLIC__/assets/js/jquery-1.11.1.min.js"></script> <script src="__PUBLIC__/assets/bootstrap/js/bootstrap.min.js"></script> <script src="__PUBLIC__/assets/js/jquery.backstretch.min.js"></script> <script src="__PUBLIC__/assets/js/scripts.js"></script> <!--[if lt IE 10]> <script src="__PUBLIC__/assets/js/placeholder.js"></script> <![endif]--> </body> </html>
<!DOCTYPE html> <head> <title>快速预约</title> <meta name="keywords" content="" /> <meta name="description" content="" /> <meta charset="UTF-8"> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <link href="__PUBLIC__/css2/font-awesome.min.css" rel="stylesheet" type="text/css"> <link href="__PUBLIC__/css2/bootstrap.min.css" rel="stylesheet" type="text/css"> <link href="__PUBLIC__/css2/bootstrap-theme.min.css" rel="stylesheet" type="text/css"> <link href="__PUBLIC__/css2/templatemo_style.css" rel="stylesheet" type="text/css"> </head> <body class="templatemo-bg-image-2"> <div class="container"> <div class="col-md-12"> <!-- <script src="__PUBLIC__/form.js"></script> --> <form class="form-horizontal templatemo-contact-form-1" role="form" action="__URL__/creat" method="post"> <div class="form-group"> <div class="col-md-12"> <h1 class="margin-bottom-15">快速预约</h1> <p>请如实填写以下信息.</p> </div> </div> <div class="form-group"> <div class="col-md-12"> <label for="username" class="control-label">姓名 *</label> <div class="templatemo-input-icon-container"> <i class="fa fa-user"></i> <input type="text" class="form-control" id="username" placeholder="" name="username"> </div> </div> </div> <div class="form-group"> <div class="col-md-6"> <label for="sex" class="control-label">性别 *</label> <div class="templatemo-input-icon-container"> <i class="fa fa-envelope-o"></i> <label class="radio-inline input-lg"> <input type="radio" name="sex" value="1" checked> 男 </label> <label class="radio-inline input-lg"> <input type="radio" name="sex" value="0"> 女 </label> </div> </div> <div class="col-md-6"> <label for="age" class="control-label">年龄 *</label> <div class="templatemo-input-icon-container"> <i class="fa fa-user"></i> <input type="age" class="form-control" id="age" placeholder="" name="age"> </div> </div> </div> <input type="hidden" name="hospital" value="常熟仁爱妇科医院"> <div class="form-group"> <div class="col-md-12"> <label for="date" class="control-label">预约时间 *</label> <div class="templatemo-input-icon-container"> <i class="fa fa-globe"></i> <input type="text" class="form-control" id="odertime" placeholder="" name="odertime"> </div> </div> </div> <div class="form-group"> <div class="col-md-12"> <label for="phone" class="control-label">手机号码 *</label> <div class="templatemo-input-icon-container"> <i class="fa fa-info-circle"></i> <input type="text" class="form-control" id="phone" placeholder="" name="phone"> </div> </div> </div> <div class="form-group"> <div class="col-md-12"> <label for="message" class="control-label">病情简述 *</label> <div class="templatemo-input-icon-container"> <i class="fa fa-pencil-square-o"></i> <textarea rows="8" cols="50" class="form-control" id="message" placeholder="" name="message"></textarea> </div> </div> </div> <div class="form-group"> <div class="col-md-6"> <label for="phone" class="control-label">验证码 *</label> <div class="templatemo-input-icon-container"> <i class="fa fa-info-circle"></i> <input type="text" class="form-control" id="code" name="code" placeholder="点击右侧图片可更换验证码"> </div> </div> <div class="col-md-6"> @@##@@ </div> </div> <div class="form-group"> <div class="col-md-12"> <input type="submit" value="申请预约" class="btn btn-success pull-right"> </div> </div> </form> </div> </div> </body> </html>
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