{include file="header.html"}
<div class="container"><div class="row">
<div class="span12">
<h1>确认换购</h1>
<form method="post" action="/index.php?m=exchange&a=order">
<input type="hidden" name="id" value="{$data.id}">
<input type="hidden" name="back_url" value="{$back_url}" />
<table class="table table-bordered">

<tr>
<td style="width:100px;"><img src="{$data.imgurl}.100x100.jpg"></td>
<td>

<p >{$data.title}</p>
<p><h3>市场价：￥<small  style="text-decoration:line-through">{$data.price}</small> 金币：{$data.lower_price}个</h3></p>
</td>
</tr>
<tr>
<td><h2  class="text-center">收获<br>地址</h2></td>
<td>
	{foreach item=c key=k from=$address}
    <p><input type="radio" name="user_address_id" {if $k eq 0} checked{/if} value="{$c.id}">地址：{$dist_list[$c.province_id]} {$dist_list[$c.city_id]} {$dist_list[$c.town_id]} {$c.address} 邮编：{$c.zip_code} 姓名：{$c.truename} 手机：{$c.telephone}</p>
    {/foreach}
</td>
</tr>

<tr>
<td><h2 class="text-center">备注</h2></td>
<td><textarea name="comment" class="span6"></textarea></td>
</tr>

<tr>
<td></td>
<td><button class="btn btn-success btn-large" type="submit">确认兑换</button></td>
</tr>
 
</table>
</form>
</div>

</div>
{include file="footer.html"}