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- <!DOCTYPE html>
- <html lang="en">
- <head>
- <meta charset="UTF-8">
- <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">
- <title></title>
- <link rel="stylesheet" href="../css/order.css">
- <style>
- body{
- padding: 0.2rem;
- }
- .page .h1{
- color: skyblue;
- font-size: 1rem;
- text-align: center;
- }
- .page .content .h2{
- font-size: 0.16rem;
- padding-left: 1rem;
- }
- .page .content .form{
- border-top: 0.2rem solid skyblue;
- box-shadow: 0 0 2.5rem rgba(75, 86, 101, 0.3);
- margin-top: 0.6rem;
- padding: 0.6rem;
- }
- .page .form .box{
- display: flex;
- margin-left:2rem;
- margin-bottom: 0.4rem;
- }
- .page .form .text{
- width: 5rem;
- display: flex;
- font-size: 0.15rem;
- font-weight: bold;
- margin: auto 0;
- }
- .page .form .text .icon{
- color: red;
- }
- .page .form .box>input{
- width: 7rem;
- height: 1.5rem;
- }
- .page .form .box .code{
- width: 5rem;
- }
- .page .form .box>button{
- border:0.15rem solid skyblue;
- margin-left: 0.8rem;
- background-color: white;
- padding-left: 0.8rem;
- padding-right: 0.8rem;
- }
-
- </style>
- </head>
- <body>
- <div class="page">
- <p class="h1">IQQA精准术前三维评估及手术规划</p>
- <div class="content">
- <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>
- <div class="form">
- <p id="warn" style="color: red; display: none;">手机号码必须要填写!</p>
- <div class="box">
- <div class="text">
- <p class="icon">*</p>
- 手机号码:
- </div>
- <input id="iphone" value="" type="text" maxlength="11" placeholder="手机号码">
- </div>
- <div class="box">
- <div class="text">
- <p class="icon">*</p>
- 姓名:
- </div>
- <input type="text" placeholder="用户姓名">
- </div>
- <div class="box">
- <div class="text">
- <p style="color: white; margin: auto 0;">*</p>
- 验证码:
- </div>
- <input class="code" type="text" placeholder="验证码">
- <button id="button">获取验证码</button>
- </div>
- </div>
- <p style="font-size: 0.16rem;padding-left: 1rem;">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>
- <div class="form">
- <div class="box">
- <div class="text">
- <p class="icon">*</p>
- 手机号码:
- </div>
- <input id="iphone" value="" type="text" placeholder="手机号码">
- </div>
- <div class="box">
- <div class="text">
- <p class="icon">*</p>
- 手机号码:
- </div>
- <input id="iphone" value="" type="text" placeholder="手机号码">
- </div>
- <div class="box">
- <div class="text">
- <p class="icon">*</p>
- 手机号码:
- </div>
- <input id="iphone" value="" type="text" placeholder="手机号码">
- </div>
- <div class="box">
- <div class="text">
- <p class="icon">*</p>
- 手机号码:
- </div>
- <input id="iphone" value="" type="text" placeholder="手机号码">
- </div>
- <div class="box">
- <div class="text">
- <p class="icon">*</p>
- 手机号码:
- </div>
- <input id="iphone" value="" type="text" placeholder="手机号码">
- </div>
- </div>
- </div>
- </div>
- </body>
- <script type="text/javascript" src="../js/jquery.min.js"></script>
- <script src="../js/distpicker.data.min.js"></script>
- <script src="../js/distpicker.min.js"></script>
- <script>
- </script>
- </html>
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