{template member/header}

<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="Mallright">
                            			<div class="Mallright1topbj"></div>
                                        <div class="Mallrightnr">
                               			  <div class="mallOutbox">
                                       		<div class="mallOutboxtitel">预存款充值</div>
                                            	<form action="" method="post" name="form1">	
                                                <input type="hidden" name="cz" value="1" />
                                                   <div class="mallRecharge">
                                                    			
                                                      <table width="700" border="0" class="mallRechargetable1">
                                                                  <tr>
                                                                    <td width="248" height="32" align="right" class="mallRechargetitel">会员卡号</td>
                                                                    <td width="10">&nbsp;</td>
                                                                    <td width="428">{$data['card_sn']}</td>
                                                                  </tr>
                                                                  <tr>
                                                                    <td width="248" height="32" align="right" class="mallRechargetitel">充值金额</td>
                                                                    <td width="10">&nbsp;</td>
                                                                    <td width="428"><input name="data[money]" type="text" size="8" value="{$price}"  class="mallRechargeinput1" />元</td>
                                                                  </tr>
                                                      </table>
                                                      
                                                      <table width="700" border="0" class="mallRechargetable2">
                                                                  <tr>
                                                                    <td colspan="2" rowspan="3" align="right" class="mallRechargetitel">&nbsp;</td>
                                                                    <td width="499" height="32" class="mallRechargetitel">请选择支付方式</td>
                                                                  </tr>
                                                                  <tr>
                                                                    <td width="499" height="63">
                                                                                  {loop $pay_config $name=>$t}
					{if $t['use']}<input class="mallRechargeradio" type="radio" value="{$name}" name="data[paytype]"><img src="{SITE_THEME}images/mall-{$name}.jpg" title="{$t['name']}">&nbsp;&nbsp;&nbsp;&nbsp;{/if}
					{/loop}
                                                                    </td>
                                                                  </tr>
                                                                 
                                                      </table>
                                                      <table width="700" border="0"   class="mallRechargetable3">
                                                                  <tr>
                                                                    <td colspan="2" rowspan="3" align="right" >&nbsp;</td>
                                                                    <td width="156" height="32" ><img src="{SITE_THEME}images/mall-38.jpg" onclick="form1.submit()" ></td>
                                                                    <td width="296" ><a href="/index.php?s=pay&c=member&a=remainder">查询余额
</a></td>
                                                                  </tr>
                                                                  <tr>
                                                                    
                                                        </tr>
                                                      </table>
                                                      
                                                      
                                                      
                                                    </div>
                                                </form>    
                               			  </div>
                                                    
                                                    
                                        </div>
                                                       <div class="clear"></div>
 <div class="Mallright1botbj"></div>
                                        
                            </div>
                            
            
            				<div class="clear"></div>
            </div>




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