{template member/header}
<link href="/views/admin/images/table_form.css" rel="stylesheet" type="text/css" />
	<link href="/views/admin/images/dialog.css" rel="stylesheet" type="text/css" />
	<script type="text/javascript" src="/views/admin/js/dialog.js"></script>
	<script type="text/javascript">var sitepath = "/index.php";</script>
    <script type="text/javascript" src="/extensions/language/zh-cn/lang.js"></script>
	<script type="text/javascript" src="/views/admin/js/core.js"></script>

<script type="text/javascript">
function checkuser() {
	$('#err_username').html("");
	$.get('{SITE_PATH}{ENTRY_SCRIPT_NAME}?s=member&c=pms&a=checkuser&id='+Math.random(), { username:$('#username').val()}, function(data){ 
	    $('#err_username').html(data);
	});
}
</script>


<div class="Mallbox">

			<div class="Mall">
            			
                       {template member/left}
                            
                           <div class="Mallrightnr">
<div class="mallOutbox">
<div class="mallOutboxtitel">健康档案</div>
<div class="mallArchives">


<form action="" method="post">
<div class="mallService">
<table width="693" border="0" class="table_form ">
			  
			   <tbody><tr>
				 <td width="100" height="25"> <strong>就诊医院</strong></td><td><input type="text" class="input-text" name="data[hospitol]" value="{$data['jiuzhenyiyuan']}"></td></tr>
			   <tr>
				 <td width="100"><strong>就诊时间</strong></td><td><link href="/extensions/calendar/jscal2.css" type="text/css" rel="stylesheet">
		<link href="/extensions/calendar/border-radius.css" type="text/css" rel="stylesheet">
		<link href="/extensions/calendar/win2k.css" type="text/css" rel="stylesheet">
		<script type="text/javascript" src="/extensions/calendar/calendar.js"></script>
		<script type="text/javascript" src="/extensions/language/zh-cn/calendar.js"></script>
		<script type="text/javascript" src="/views/admin/js/jquery-ui.min.js"></script>
	<input type="hidden" value="" name="data[jiuzhenshijian]" id="fc_jiuzhenshijian">
	<input type="text" readonly="" class="date input-text" style="width:150px;" value="{date("Y-m-d",$data['jiuzhenshijian'])}" id="jiuzhenshijian">
	<script type="text/javascript">
		Calendar.setup({
		weekNumbers : true,
		inputField  : "jiuzhenshijian",
		trigger     : "jiuzhenshijian",
		dateFormat  : "%Y-%m-%d %H:%M:%S",
		showTime    : true,
		minuteStep  : 1,
		onSelect    : function() {
			this.hide();
			var time = $("#jiuzhenshijian").val();
			var date = (new Date(Date.parse(time.replace(/-/g,"/")))).getTime() / 1000;
			$("#fc_jiuzhenshijian").val(date);
		}
		});
    </script><span id="ck_jiuzhenshijian"></span></td></tr>
				 <tr>
				 <td width="100"> <strong>就诊科室</strong></td><td><input type="text" class="input-text" name="data[class]" value="试试1"></td></tr>
				 
				<tr>
					<td width="100"> <strong>上传文件</strong></td>
					<td>
														<div id="div_0">{basename($data['shangchuanwenjian'])}&nbsp;&nbsp;<a href="javascript:;" onclick="getElementById('ylChild').src='{$data['shangchuanwenjian']}';getElementById('yl').style.display = ''">预览</a>&nbsp;&nbsp;<a href="{$data['shangchuanwenjian']}" target="_blank">下载</a>&nbsp;&nbsp;<a href="#" onclick="del_img(0)">删除</a><input type="hidden" id="images_0" name="data[Filedata][file][]" value="{$data['shangchuanwenjian']}"><input type="hidden" id="alt_0" name="data[Filedata][alt][]" value="7"></div>
													<ul id="Filedata-sort-items"></ul>
													<input type="hidden" value="{$data['shangchuanwenjian']}" name="data[shangchuanwenjian]" id="fc_shangchuanwenjian">
						<!--<input id="Filedata" class="input-text" type="text" name="data[thumb]" value="" size="50">-->
						<!--<input class="button" type="button" value="上传文件" onclick="uploadFile('thumb', 'jpg,png,bmp,pdf,rar,zip', 20)" style="width:66px;cursor:pointer;">-->
						<input class="button" type="button" value="上传文件" onclick="uploadFile('fc_shangchuanwenjian','anBnLHBuZyx3b3JkLHBwdCxnaWY=','2')" style="width:66px;cursor:pointer;">					</td>
				</tr>
				<tr id="yl" style="display:none;">
					<td><strong>预览</strong></td>
					<td><img id="ylChild">
					<a href="javascript:;" onclick="getElementById('yl').style.display = 'none'">隐藏</a>
					</td>
				</tr>
				

				 <tr>
				 <td width="100"> <strong>留言</strong></td><td><textarea name="data[content]" style="background: none repeat scroll 0 0 #F6F6F6;border: 1px solid #D6D6D6; height: 150px;padding: 5px;
width: 410px;">{$data['liuyan']}</textarea><input type="hidden" name="old_content" value=""></td></tr>

<tr><td colspan="2"><input class="button" type="submit" name="submit" value="" style="width:58px; min-width:58px; cursor: pointer; float: right;margin-right: 50px;margin-top: 5px; background:url('/views/lvyu/member/images/mall-32.jpg') no-repeat scroll 0 0 rgba(0, 0, 0, 0)"></td></tr>
			  
  

</tbody></table>


</div>
</form>

</div>



</div>


</div>
                            
            
            				<div class="clear"></div>
            </div>




            {template hospitalphoto}
     
     
</div>     
     
{template member/footer}