vocs.com/application/admin/view/entrust/add.html

<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">


    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-name" data-rule="" class="form-control" name="row[name]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Bach')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-bach" data-rule="" class="form-control" name="row[bach]" type="text">
        </div>
    </div>

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Sell_bach')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-sell_bach" data-rule="" class="form-control" name="row[sell_bach]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">样品数量:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-num" data-rule="required" class="form-control" name="row[num]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">样品信息:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-sample_info" class="form-control" name="row[sample_info]" type="text" >
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('送样单位')}:</label>
        <div class="col-xs-12 col-sm-8">
<!--            <input id="c-company" data-rule="required" class="form-control" name="row[company]" >-->
            {:build_select('row[company]', $company, null,['class'=>'form-control company'])}
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">样品代号:</label>
        <div class="col-xs-12 col-sm-8">
            {:build_select('mark', ['0'=>'请选择','1'=>'A:出厂成品样', '2'=>'B:半成品样', '3'=>'C:材料样', '4'=>'D:翌星送样'], null,['class'=>'form-control mark'])}
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Manufacturer')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-manufacturer" data-rule="required" class="form-control" name="row[manufacturer]" type="text" value="" >
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Sample_no')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-sample_no" data-rule="required" class="form-control" name="row[sample_no]" type="text" value="" readonly>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('No')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-no" data-rule="required" class="form-control" name="row[no]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">是否双样:</label>
        <div class="col-xs-12 col-sm-8">
            {:build_select('row[is_two]', ['0'=>'否', '1'=>'是'], null,['class'=>'form-control'])}
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">是否加急:</label>
        <div class="col-xs-12 col-sm-8">
            {:build_select('row[is_urgent]', ['0'=>'不加急', '1'=>'加急'], null,['class'=>'form-control'])}
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">送样人:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-send_sample" data-rule="required" class="form-control" name="row[send_sample]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">收样人:</label>
        <div class="col-xs-12 col-sm-8">
            {:build_select('row[receive_sample]', ['王枫'=>'王枫', '邹细建'=>'邹细建','高小满'=>'高小满','顾诚康'=>'顾诚康',], null,['class'=>'form-control'])}
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Sample_status')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-sample_status" data-rule="required" class="form-control" name="row[sample_status]" type="text" value="密封">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Create')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-create" data-rule="required" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[create]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Status')}:</label>
        <div class="col-xs-12 col-sm-8">
            
            <div class="radio">
            {foreach name="statusList" item="vo"}
            <label for="row[status]-{$key}"><input id="row[status]-{$key}" name="row[status]" type="radio" value="{$key}" {in name="key" value="1"}checked{/in} /> {$vo}</label> 
            {/foreach}
            </div>

        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">检测项目:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="check">
                <label >
                    <input name="row[project][]" type="checkbox" value="voc" checked>voc
<!--                    <input name="row[project][]" type="checkbox" value="甲醛" checked>甲醛-->
                </label>
            </div>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Remark')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="col-xs-12 col-sm-8">
                <div class="check">

                    <label>
                        <input name="row[remark]" type="radio" value="正式报告" >正式报告
                        <input name="row[remark]" type="radio" value="简化报告" checked>简化报告
                        <input name="row[remark]" type="radio" value="检测数据" >检测数据
                    </label>
                </div>
            </div>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">检后样品处理要求:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="col-xs-12 col-sm-8">
                <div class="check">
                    <label >
                        <input name="row[sample_request]" type="radio" value="委托方取回" >委托方取回
                        <input name="row[sample_request]" type="radio" value="本中心处理" checked>本中心处理
                    </label>
                </div>
            </div>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">报告发放:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="col-xs-12 col-sm-8">
                <div class="check">
                    <label>
                        <input name="row[report_grant][]" type="checkbox" value="自取" />自取
                    </label>
                    <label>
                        <input name="row[report_grant][]" type="checkbox" value="邮寄" />邮寄
                    </label>
                    <label>
                        <input name="row[report_grant][]" type="checkbox" value="传真" />传真
                    </label>
                    <label>
                        <input name="row[report_grant][]" type="checkbox" value="邮箱" checked />邮箱
                    </label>
                </div>
            </div>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">检测依据标准:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="col-xs-12 col-sm-8">
                <div class="check">
                    <label >
                        <input name="row[sample_stand][]" type="checkbox" value="YC/T 207-2014" >YC/T 207-2014
                    </label>
                    <label >
                        <input name="row[sample_stand][]" type="checkbox" value="YQ/T 35-2013" >YQ/T 35-2013
                    </label>
                    <label >
                        <input name="row[sample_stand][]" type="checkbox" value="GB/T 7974-2013" >GB/T 7974-2013
                    </label>
                    <label >
                        <input name="row[sample_stand][]" type="checkbox" value="GB/T 18348-2008" >GB/T 18348-2008
                    </label>
                    <label >
                        <input name="row[sample_stand][]" type="checkbox" value="其他" >其他
                    </label>
                </div>
            </div>
        </div>
    </div>
<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('Report_id')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <input id="c-report_id" data-rule="required" data-source="report/index" class="form-control selectpage" name="row[report_id]" type="text" value="">-->
<!--        </div>-->
<!--    </div>-->
<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('User_id')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <input id="c-user_id" data-rule="required" data-source="user/user/index" data-field="nickname" class="form-control selectpage" name="row[user_id]" type="text" value="">-->
<!--        </div>-->
<!--    </div>-->
<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('User_name')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <input id="c-user_name" class="form-control" name="row[user_name]" type="text">-->
<!--        </div>-->
<!--    </div>-->
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>