微信公众平台开发（61）预约挂号

最新推荐文章于 2024-01-16 16:28:46 发布

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最新推荐文章于 2024-01-16 16:28:46 发布

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文章标签： javascript php ViewUI

微信公众平台开发微信公众平台开发模式企业微信公众平台医院挂号预约挂号在线挂号
作者：方倍工作室
地址：http://www.cnblogs.com/txw1958/p/weixin61-appointment-register.html

<!DOCTYPE HTML>
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=gb2312">
<meta content="width=device-width, initial-scale=1.0, maximum-scale=1.0, user-scalable=0" name="viewport" />
<meta name='apple-mobile-web-app-capable' content='yes' />
<meta content="black" name="apple-mobile-web-app-status-bar-style" />
<meta content="telephone=yes" name="format-detection" />
<title>微站</title>
<link href="/css/jquery.mobile-1.3.1.min.css" type="text/css" rel="stylesheet">
<link href="/css/styles.css" rel="stylesheet" type="text/css">
<script type="text/javascript" src="/js/jquery-1.7.2.js"></script>
<script type="text/javascript" src="/js/jquery.mobile-1.3.1.min.js"></script>
<script type="text/javascript" src="/js/v1.js"></script>
</head>

<body>
<div data-role="page">
  <div class="headerWrap" data-position="fixed" data-role="header" data-theme="c">
    <a href="javascript:windowBack()" class="back1" data-icon="back" data-transition="fade">返回</a>

    <h1>在线挂号</h1>
  </div>
  <div class="cttdlWrap">
   <form action="save.php?action=add" method="post" >
    <dl class="cttdl">
      <dt>
        <label for="text-1">姓 名</label>
      </dt>
      <dd>
        <input type="text" data-clear-btn="true" name="FaqTitle" id="text-1" value="" placeholder="姓名">
      </dd>
      <dt>
        <label>性 别</label>
      </dt>
      <dd>
        <select name="FaqSex">
          <option  value="male">男</option>
          <option  value="female">女</option>
        </select>
      </dd>
      <dt>
        <label for="text-3">年 龄</label>
      </dt>
      <dd>
        <input type="text" data-clear-btn="true" name="FaqAddress" id="text-3" value="" placeholder="年龄">
      </dd>
      <dt>
        <label for="text-4">联系电话</label>
      </dt>
      <dd>
        <input type="text" data-clear-btn="true" name="FaqMobile" id="text-4" value="" placeholder="联系电话">
      </dd>
      <dt>
        <label>预约科室</label>
      </dt>
      <dd>
       <input type="text" data-clear-btn="true" name="FaqTel" value="" placeholder="预约科室">
      </dd>
        <dt>
        <label>预约内容</label>
      </dt>
      <dd><textarea data-clear-btn="true" name="FaqWeb" id="guahaoTextarea"></textarea></dd>
    </dl>
    <div class="clearfix"></div>
    <div id="sendbtn"> <input type="submit" value="提交" data-theme="b" /></div>
   </form>
  </div>
</div>
</body>
</html>