order_20210402124252.html 4.7 KB

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  1. <!DOCTYPE html>
  2. <html lang="en">
  3. <head>
  4. <meta charset="UTF-8">
  5. <meta name="viewport" content="width=device-width, initial-scale=1.0, user-scalable=0, minimum-scale=1.0, maximum-scale=1.0,viewport-fit=cover">
  6. <title></title>
  7. <link rel="stylesheet" href="../css/order.css">
  8. <style>
  9. body{
  10. padding: 0.2rem;
  11. }
  12. .page .h1{
  13. color: skyblue;
  14. font-size: 1rem;
  15. text-align: center;
  16. }
  17. .page .content .h2{
  18. font-size: 0.16rem;
  19. padding-left: 1rem;
  20. }
  21. .page .content .form{
  22. border-top: 0.2rem solid skyblue;
  23. box-shadow: 0 0 2.5rem rgba(75, 86, 101, 0.3);
  24. margin-top: 0.6rem;
  25. padding: 0.6rem;
  26. }
  27. .page .form .box{
  28. display: flex;
  29. margin-left:2rem;
  30. margin-bottom: 0.4rem;
  31. }
  32. .page .form .text{
  33. width: 5rem;
  34. display: flex;
  35. font-size: 0.15rem;
  36. font-weight: bold;
  37. margin: auto 0;
  38. }
  39. .page .form .text .icon{
  40. color: red;
  41. }
  42. .page .form .box>input{
  43. width: 7rem;
  44. height: 1.5rem;
  45. }
  46. .page .form .box .code{
  47. width: 5rem;
  48. }
  49. .page .form .box>button{
  50. border:0.15rem solid skyblue;
  51. margin-left: 0.8rem;
  52. background-color: white;
  53. padding-left: 0.8rem;
  54. padding-right: 0.8rem;
  55. }
  56. </style>
  57. </head>
  58. <body>
  59. <div class="page">
  60. <p class="h1">IQQA精准术前三维评估及手术规划</p>
  61. <div class="content">
  62. <p class="h2">请告诉我们您的手机号码,使我们能够及时通知到您服务的进度。</p>
  63. <div class="form">
  64. <p id="warn" style="color: red; display: none;">手机号码必须要填写!</p>
  65. <div class="box">
  66. <div class="text">
  67. <p class="icon">*</p>
  68. 手机号码:
  69. </div>
  70. <input id="iphone" value="" type="text" maxlength="11" placeholder="手机号码">
  71. </div>
  72. <div class="box">
  73. <div class="text">
  74. <p class="icon">*</p>
  75. 姓名:
  76. </div>
  77. <input type="text" placeholder="用户姓名">
  78. </div>
  79. <div class="box">
  80. <div class="text">
  81. <p style="color: white; margin: auto 0;">*</p>
  82. 验证码:
  83. </div>
  84. <input class="code" type="text" placeholder="验证码">
  85. <button id="button">获取验证码</button>
  86. </div>
  87. </div>
  88. <p style="font-size: 0.16rem;padding-left: 1rem;margin-top: 1.2rem;">请确认病人是否正确,医生在查看报告时,会核对此处的姓名。</p>
  89. <div class="form">
  90. <div class="box">
  91. <div class="text">
  92. <p class="icon">*</p>
  93. 手机号码:
  94. </div>
  95. <input id="iphone" value="" type="text" placeholder="手机号码">
  96. </div>
  97. <div class="box">
  98. <div class="text">
  99. <p class="icon">*</p>
  100. 手机号码:
  101. </div>
  102. <input id="iphone" value="" type="text" placeholder="手机号码">
  103. </div>
  104. <div class="box">
  105. <div class="text">
  106. <p class="icon">*</p>
  107. 手机号码:
  108. </div>
  109. <input id="iphone" value="" type="text" placeholder="手机号码">
  110. </div>
  111. <div class="box">
  112. <div class="text">
  113. <p class="icon">*</p>
  114. 手机号码:
  115. </div>
  116. <input id="iphone" value="" type="text" placeholder="手机号码">
  117. </div>
  118. <div class="box">
  119. <div class="text">
  120. <p class="icon">*</p>
  121. 手机号码:
  122. </div>
  123. <input id="iphone" value="" type="text" placeholder="手机号码">
  124. </div>
  125. </div>
  126. </div>
  127. </div>
  128. </body>
  129. <script type="text/javascript" src="../js/jquery.min.js"></script>
  130. <script src="../js/distpicker.data.min.js"></script>
  131. <script src="../js/distpicker.min.js"></script>
  132. <script>
  133. </script>
  134. </html>