ywt
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nfywt-wx


			
				
					
						
						
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							<!DOCTYPE html>
<html style="overflow: visible">
<head>
    <meta charset="utf-8">
    <title>南方医务通</title>
    <link type="text/css" rel="stylesheet" href="css/icoline.min.css">
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          content="width=device-width,initial-scale=1.0,maximum-scale=1.0,minimum-scale=1.0,user-scalable=no">
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</head>

<body style="overflow: visible">

<header id="header" class="head">

    <div class="wrap">

        <i class="menu_back icon-arrow-left"></i>

        <div class="title">

            <span class="title_d"><p>添加家庭成员</p></span>

            <div class="clear"></div>

        </div>

        <i class="menu_cn">保存</i>

    </div>

</header>

<article id="container" class="containerInput">

    <section id="content" class="content">

        <div class="lists">

            <form id="testForm">

                <div class="wrap">

                    <div class="tips"><i class="icon-comment"></i> 姓名、手机号码、身份证号码提交后不能修改</div>
                    <ul style="display: block;">
                        <li class="line1">
                            <div class="title">与本人关系</div>
                            <div class="word table">
                                <select id="ownership" required="select">
                                    <option value="父母">父母</option>
                                    <option value="兄弟">兄弟</option>
                                    <option value="姐妹">姐妹</option>
                                    <option value="子女">子女</option>
                                    <option value="夫妻">夫妻</option>
                                    <option value="其它">其它</option>
                                </select>
                            </div>
                        </li>
                        <li class="line1">
                            <div class="title">真实姓名</div>
                            <div class="word table"><input class="red" id="trueName" required></div>
                        </li>
                        <li class="line1">
                            <div class="title">性别</div>
                            <div class="word table">
                                <select id="sex" required="select">
                                    <option selected="selected" value="男">男</option>
                                    <option value="女">女</option>
                                </select>
                            </div>
                        </li>
                        <li class="line1">
                            <div class="title">民族</div>
                            <div class="word table">
                                <select id="nation" required="select">
                                    <option selected="selected" value="汉族">汉族</option>
                                    <option value="蒙古族">蒙古族</option>
                                    <option value="彝族">彝族</option>
                                    <option value="侗族">侗族</option>
                                    <option value="哈萨克族">哈萨克族</option>
                                    <option value="畲族">畲族</option>
                                    <option value="纳西族">纳西族</option>
                                    <option value="仫佬族">仫佬族</option>
                                    <option value="仡佬族">仡佬族</option>
                                    <option value="怒族">怒族</option>
                                    <option value="保安族">保安族</option>
                                    <option value="鄂伦春族">鄂伦春族</option>
                                    <option value="回族">回族</option>
                                    <option value="壮族">壮族</option>
                                    <option value="瑶族">瑶族</option>
                                    <option value="傣族">傣族</option>
                                    <option value="高山族">高山族</option>
                                    <option value="景颇族">景颇族</option>
                                    <option value="羌族">羌族</option>
                                    <option value="锡伯族">锡伯族</option>
                                    <option value="乌孜别克族">乌孜别克族</option>
                                    <option value="裕固族">裕固族</option>
                                    <option value="赫哲族">赫哲族</option>
                                    <option value="藏族">藏族</option>
                                    <option value="布依族">布依族</option>
                                    <option value="白族">白族</option>
                                    <option value="黎族">黎族</option>
                                    <option value="拉祜族">拉祜族</option>
                                    <option value="柯尔克孜族">柯尔克孜族</option>
                                    <option value="布朗族">布朗族</option>
                                    <option value="阿昌族">阿昌族</option>
                                    <option value="俄罗斯族">俄罗斯族</option>
                                    <option value="京族">京族</option>
                                    <option value="门巴族">门巴族</option>
                                    <option value="维吾尔族">维吾尔族</option>
                                    <option value="朝鲜族">朝鲜族</option>
                                    <option value="土家族">土家族</option>
                                    <option value="傈僳族">傈僳族</option>
                                    <option value="水族">水族</option>
                                    <option value="土族">土族</option>
                                    <option value="撒拉族">撒拉族</option>
                                    <option value="普米族">普米族</option>
                                    <option value="鄂温克族">鄂温克族</option>
                                    <option value="塔塔尔族">塔塔尔族</option>
                                    <option value="珞巴族">珞巴族</option>
                                    <option value="苗族">苗族</option>
                                    <option value="满族">满族</option>
                                    <option value="哈尼族">哈尼族</option>
                                    <option value="佤族">佤族</option>
                                    <option value="东乡族">东乡族</option>
                                    <option value="达斡尔族">达斡尔族</option>
                                    <option value="毛南族">毛南族</option>
                                    <option value="塔吉克族">塔吉克族</option>
                                    <option value="德昂族">德昂族</option>
                                    <option value="独龙族">独龙族</option>
                                    <option value="基诺族">基诺族</option>
                                </select>
                            </div>
                        </li>
                        <li class="line1">
                            <div class="title">手机号码</div>
                            <div class="word table">
                                <input class="red" id="phone" required="phone">
                            </div>
                        </li>
                        <li class="line1">
                            <div class="title">电话</div>
                            <div class="word table"><input id="tel" placeholder="格式:020-61641888" format="tel">
                            </div>
                        </li>
                        <li class="line1">
                            <div class="title">电子邮箱</div>
                            <div class="word table"><input id="email" format="email" placeholder="格式:aa@aa.com">
                            </div>
                        </li>
                        <li class="line1">
                            <div class="title">身份证号码</div>
                            <div class="word table"><input class="red" id="idNo" required="idNo"></div>
                        </li>
                        <li class="line1">
                            <div class="title">常住地址</div>
                            <div class="word table"><input id="address" required="address"></div>
                        </li>
                        <li class="line1">
                            <div class="padl14">
                                <a id="iDataAdd" class="btn btn-ok btn-large">保存</a>
                            </div>
                        </li>
                    </ul>

                </div>

                <div class="reSize"></div>

            </form>

        </div>

    </section>

</article>

<div id="dialog" class="popup_layer">

    <div class="popup_msk"></div>

    <div class="popup_layer_cont dialog">

        <div class="loading_cont">

        </div>

    </div>

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</body>

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