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yxxw-html/upload.html

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lee
2022-05-09 09:38:38 +00:00
<!DOCTYPE html>
<html lang="zh-cmn-Hans">
<head>
<meta charset="utf-8" />
<meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1" />
<meta name ="viewport" content ="initial-scale=1, maximum-scale=3, minimum-scale=1, user-scalable=no">
<meta name="description" content="一线希望" />
<meta name="keywords" content="一线希望" />
<meta name="applicable-device" content="pc,mobile" />
<meta name="MobileOptimized" content="width" />
<meta name="HandheldFriendly" content="true" />
<meta name="robots" content="noarchive"/>
<meta name="google" value="notranslate">
<link rel="shortcut icon" type="image/ico" href="favicon.ico" />
<title>上传患者信息-一线希望</title>
<link rel="stylesheet" type="text/css" href="./css/swiper-bundle.min.css"/>
<link rel="stylesheet" type="text/css" href="./css/animate.min.css"/>
<link rel="stylesheet" type="text/css" href="./css/base.css"/>
<link rel="stylesheet" type="text/css" href="./css/style.css"/>
<script src="./js/jquery-3.6.0.min.js" type="text/javascript" charset="utf-8"></script>
<script src="./js/swiper-bundle.min.js" type="text/javascript" charset="utf-8"></script>
<script src="./js/swiper.animate1.0.3.min.js" type="text/javascript" charset="utf-8"></script>
<script src="./js/wow.js" type="text/javascript" charset="utf-8"></script>
<script src="./js/my-site.js" type="text/javascript" charset="utf-8"></script>
</head>
<body>
<!-- 头部导航 -->
<header class="header w100">
<div class="head w1140">
<!-- logo -->
<h1 class="logo">
<a href="index.html"><img src="images/logo.png" alt="一线希望" title="一线希望"></a>
</h1>
<!-- 导航 -->
<ul class="nav">
<li class="active"><a href="solid.html">实体瘤</a></li>
<li><a href="blood.html">血液肿瘤</a></li>
<li><a href="other.html">其他</a></li>
<li><a href="operation.html">操作指南</a></li>
</ul>
<!-- 顶部右侧 -->
<div class="top-right">
<!-- 通知 -->
<div class="notice"><a href="">通知</a></div>
<!-- 登录/注册 -->
<div class="login-registration">
<ins><img src="images/icon/icon-user.png" alt="登录/注册"></ins>
<span><em><a href="login.html">高高兴</a></em></span>
<em class="icon-arrow"></em>
</div>
</div>
<!-- 导航按钮 -->
<div class="nav-bg"></div>
<div class="head-btn">
<i class="bar-top"></i>
<i class="bar-cen"></i>
<i class="bar-bom"></i>
</div>
</div>
</header>
<!-- 主体内容 -->
<div class="main w1140 wow fadeInUp">
<div class="survey wow fadeInUp">
<div class="survey-left wow fadeInUp">
<span><img src="images/avatar.png" alt="高高兴"></span>
<section>
<h2>高高兴</h2>
<p>联系方式：13852526255</p>
</section>
</div>
<div class="survey-right wow fadeInUp">
<span>账户余额：<strong>5526.00</strong></span>
<button class="withdrawal-btn">立即提现</button>
</div>
</div>
<!-- 二级导航 -->
lee
2022-05-11 01:59:14 +00:00
<div class="pull-nav wow fadeInUp">
lee
2022-05-09 09:38:38 +00:00
<div class="pull-nav-swiper swiper">
<div class="swiper-wrapper">
<div class="swiper-slide">
<a href="user.html">个人资料</a>
</div>
<div class="swiper-slide">
<a href="upload.html" class="active">上传患者信息</a>
</div>
<div class="swiper-slide">
<a href="patient.html">患者信息列表</a>
</div>
<div class="swiper-slide">
<a href="withdrawal.html">提现记录</a>
</div>
</div>
</div>
</div>
lee
2022-05-11 01:17:11 +00:00
<!-- 表单 -->
<div class="information information-upload">
<h2>基本信息</h2>
<ul class="information-list">
<li class="wow fadeInUp">
<span>患者姓名<em>*</em></span>
<section class="select-section">
<input name="name-initials" type="text" placeholder="患者姓名首字母" value="">
<input name="patient-code" type="text" readonly="readonly" placeholder="生成患者代号" value="">
</section>
</li>
<li class="wow fadeInUp">
<span>患者性别<em>*</em></span>
<section class="radio-section">
<span><em class="sex checked"><ins></ins></em>男士</span>
<span><em class="sex"><ins></ins></em>女士</span>
</section>
</li>
<li class="wow fadeInUp">
<span>出生日期<em>*</em></span>
<section class="select-section">
<select name="birth-tiem">
<option value="">请选择出生日期</option>
<option value="">1985年</option>
<option value="">1986年</option>
</select>
<select name="age">
<option value="">请选择年龄</option>
<option value="">25</option>
<option value="">26</option>
</select>
</section>
</li>
<li class="wow fadeInUp">
<span>患者常驻地址<em>*</em></span>
<section class="select-section">
<select name="province">
<option value="">四川</option>
<option value="">上海</option>
<option value="">广州</option>
</select>
<select name="city">
<option value="">成都</option>
<option value="">南充</option>
<option value="">绵阳</option>
</select>
<select name="area">
<option value="">金牛区</option>
<option value="">武侯区</option>
<option value="">锦江区</option>
</select>
<input type="text" placeholder="请填写详细信息" value="">
</section>
</li>
<li class="wow fadeInUp">
<span>能接受就医城市<em>*</em></span>
<section class="select-section">
<select name="province">
<option value="">四川</option>
<option value="">上海</option>
<option value="">广州</option>
</select>
<select name="city">
<option value="">成都</option>
<option value="">南充</option>
<option value="">绵阳</option>
</select>
<select name="area">
<option value="">金牛区</option>
<option value="">武侯区</option>
<option value="">锦江区</option>
</select>
</section>
</li>
</ul>
<h2>预诊信息</h2>
<ul class="information-list">
<li class="wow fadeInUp">
<span>主要诊断<em>*</em></span>
<section class="select-section">
<select name="first-column">
<option value="">实体瘤</option>
<option value="">实体瘤</option>
<option value="">实体瘤</option>
</select>
<select name="second-column">
<option value="">血液肿瘤</option>
<option value="">血液肿瘤</option>
<option value="">血液肿瘤</option>
</select>
<select name="third-column">
<option value="">三级菜单名</option>
<option value="">三级菜单名</option>
<option value="">三级菜单名</option>
</select>
</section>
</li>
<li class="wow fadeInUp">
<span>首次诊断日期<em>*</em></span>
<section class="select-section">
<select name="diagnosis-time">
<option value="">请选择首次诊断日期</option>
<option value="">1985</option>
<option value="">1986</option>
</select>
</section>
</li>
<li class="wow fadeInUp">
<span>详细信息<em>*</em></span>
<section>
<textarea name="msg" placeholder="请填写患者详细信息"></textarea>
</section>
</li>
<li class="wow fadeInUp">
<span>上传病例或者检查信息<em>*</em></span>
<section class="upload-section">
<span><img src="images/avatar.png" alt="病例或者检查信息"></span>
<button><img src="images/icon/icon-add.png" alt="上传"></button>
</section>
</li>
</ul>
<button class="information-btn wow fadeInUp">确认提交</button>
lee
2022-05-09 10:12:29 +00:00
</div>
lee
2022-05-09 09:38:38 +00:00
</div>
<!-- 尾部 -->
<div class="footer w100 wow fadeInUp" data-wow-duration=".8s" data-wow-delay="0">
<div class="foot w1140 wow fadeInUp">
<div class="foot-nav">
<a href="">合作协议</a><a href="">关于我们</a><a href="">意见反馈</a>
</div>
<div class="foot-record">Copyright© xxxxxxxxx.com All rights reserved<a href="https://beian.miit.gov.cn">蜀ICP备11111111号-2</a>技术支持：<a href="">大向天成</a></div>
</div>
</div>
</body>
</html>