index.blade.php 11 KB

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  1. <!DOCTYPE html>
  2. <html lang="zh-cn">
  3. <head>
  4. <meta name="viewport" content="width=device-width,minimum-scale=1.0,maximum-scale=1.0,user-scalable=no">
  5. <link href="{{cdn_asset('/assets/css/bootstrap.min.css')}}" rel="stylesheet">
  6. <title>tijian</title>
  7. <script type="text/javascript">
  8. (function (doc, win) {
  9. var docEl = doc.documentElement,
  10. resizeEvt = 'orientationchange' in window ? 'orientationchange' : 'resize',
  11. recalc = function () {
  12. var clientWidth = docEl.clientWidth;
  13. if (!clientWidth) return;
  14. if(clientWidth>=640){
  15. docEl.style.fontSize = '100px';
  16. }else{
  17. docEl.style.fontSize = 100 * (clientWidth / 640) + 'px';
  18. }
  19. };
  20. if (!doc.addEventListener) return;
  21. win.addEventListener(resizeEvt, recalc, false);
  22. doc.addEventListener('DOMContentLoaded', recalc, false);
  23. })(document, window);
  24. </script>
  25. <style type="text/css">
  26. .all{
  27. width: 100%;
  28. height: auto;
  29. }
  30. img{
  31. width: 50px;
  32. height: 50px;
  33. margin-top: 3px;
  34. }
  35. h3{
  36. text-align: center;
  37. }
  38. .all .main{
  39. flex-wrap: wrap;
  40. display: flex;
  41. }
  42. .all .input-group{
  43. margin:4px 6%;
  44. }
  45. .all .danxuan{
  46. width: 66.66%;
  47. margin: 4px 16.66%;
  48. }
  49. #tanchuang{
  50. position: fixed;
  51. z-index: 999;
  52. width: 100%;
  53. height: 100%;
  54. top: 0;
  55. left: 0;
  56. background: rgba(0,0,0,0.5);
  57. }
  58. #tanchuang .tanbox{
  59. width: 240px;
  60. height: 120px;
  61. background: #fff;
  62. position: absolute;
  63. left: 50%;
  64. top: 50%;
  65. margin-left: -120px;
  66. margin-top: -60px;
  67. border-radius: 15px;
  68. }
  69. .tanbox .status{
  70. width: 80%;
  71. height: 70%;
  72. margin: 10%;
  73. }
  74. .tanbox .status text{
  75. display: inline-block;
  76. width: 100%;
  77. text-align: center;
  78. margin-top: 10px;
  79. }
  80. .tanbox .status .title{
  81. display: inline-block;
  82. width: 100%;
  83. font-size: 20px;
  84. font-weight: 700;
  85. text-align: center;
  86. color: #f04;
  87. margin-top: 10px;
  88. }
  89. </style>
  90. </head>
  91. <body>
  92. <script type="text/javascript">
  93. var yan = 0;
  94. var countdown = 60;
  95. var sending = false;
  96. function settime(obj) { //发送验证码倒计时
  97. console.log(obj)
  98. if (countdown == 0) {
  99. obj.attr('disabled', false);
  100. obj.val("发送验证码");
  101. countdown = 60;
  102. sending = false;
  103. return;
  104. } else {
  105. obj.attr('disabled', true);
  106. obj.val("重新发送(" + countdown + ")");
  107. countdown--;
  108. }
  109. setTimeout(function () {
  110. settime(obj);
  111. }, 1000)
  112. }
  113. function tijiao(){
  114. var tanc=document.getElementById("tanchuang")
  115. tanc.style="display:auto;"
  116. var status = 0
  117. var tbox = document.getElementsByClassName("status");
  118. if(status==0){
  119. tbox[0].style="display:auto;"
  120. tbox[1].style="display:none;"
  121. tbox[2].style="display:none;"
  122. }else if(status==1){
  123. tbox[1].style="display:auto;"
  124. tbox[0].style="display:none;"
  125. tbox[2].style="display:none;"
  126. }else{
  127. tbox[1].style="display:none;"
  128. tbox[0].style="display:none;"
  129. tbox[2].style="display:auto;"
  130. }
  131. }
  132. function close(e){
  133. var id = e.id;
  134. console.log(id)
  135. if(id=='fail'){
  136. closebox();
  137. }else if(id=='yeah'){
  138. var tanc=document.getElementById("tanchuang")
  139. tanc.style="display:none;"
  140. }else if(id=='download'){
  141. var tanc=document.getElementById("tanchuang")
  142. tanc.style="display:none;"
  143. }
  144. }
  145. function closebox(){
  146. var tanc=document.getElementById("tanchuang")
  147. tanc.style="display:none;"
  148. }
  149. function phonenum() {
  150. var phone = '17828477741'
  151. var myreg=/^[1][3,4,5,7,8][0-9]{9}$/;
  152. if (!myreg.test(phone)) {
  153. console.log('错了')
  154. } else {
  155. console.log('对了')
  156. }
  157. }
  158. function closeyan(){
  159. var yanz=document.getElementById("yanz")
  160. yanz.style="display:none;"
  161. }
  162. function yanzhengma(){
  163. var yanzheng = document.getElementById("yzma")
  164. yanzheng.style="display:auto;"
  165. console.log('aaa')
  166. sending = true;
  167. var obj = $("#fasong");
  168. settime(obj);
  169. }
  170. </script>
  171. <div class="all">
  172. <div class="col-xs-0 col-lg-2"></div>
  173. <div class="col-xs-12 col-lg-8 main" style="margin: 0 auto;margin-top: 10px;">
  174. <div class="col-xs-12 col-lg-12 imgbox" style="width:100%;margin-bottom:20px;display: flex;height: auto;">
  175. <div class="col-xs-0 col-lg-2"></div>
  176. <img class="col-xs-3 col-lg-1" src="{{cdn_asset('/assets/img/logo.jpg')}}">
  177. <h3 class="col-lg-8">健康体检服务知情同意书</h3>
  178. </div>
  179. <form class="bs-example bs-example-form main" role="form">
  180. <div class="col-xs-12 col-lg-4 input-group input">
  181. <span class="input-group-addon">姓名:</span>
  182. <input type="text" class="form-control" name="name" placeholder="请输入姓名" required>
  183. </div>
  184. <div class="col-xs-12 col-lg-4 input-group input">
  185. <span class="input-group-addon">籍贯:</span>
  186. <input type="text" class="form-control" name="native_place" placeholder="请输入籍贯" required>
  187. </div>
  188. <div class="col-xs-12 col-lg-4 input-group input">
  189. <span class="input-group-addon">民族:</span>
  190. <input type="text" class="form-control" name="nationality" placeholder="请输入民族" required>
  191. </div>
  192. <div class="col-xs-12 col-lg-4 input-group input">
  193. <span class="input-group-addon">年龄:</span>
  194. <input type="text" class="form-control" name="age" placeholder="请输入年龄" required>
  195. </div>
  196. <div class="col-xs-12 col-lg-4 input-group input">
  197. <span class="input-group-addon">职业:</span>
  198. <input type="text" class="form-control" name="work" placeholder="请输入职业" required>
  199. </div>
  200. <div class="col-xs-12 col-lg-4 input-group input">
  201. <span class="input-group-addon">邮箱地址:</span>
  202. <input type="text" class="form-control" name="email" placeholder="请输入邮箱" required>
  203. </div>
  204. <div class="col-xs-12 col-lg-6 input-group">
  205. <span class="input-group-addon">住址:</span>
  206. <input type="text" class="form-control" name="address" placeholder="请输入住址" required>
  207. </div>
  208. <div class="col-xs-12 col-lg-12 input-group" style="display: flex;flex-wrap: wrap;">
  209. <div class="col-xs-12 col-lg-6 input-group" style="display: flex;margin:4px 0;">
  210. <span style="width: 20%;line-height: 20px;font-size: 10px;" class="input-group-addon">手机号</span>
  211. <input style="width: 44%;" type="text" name="phone" class="form-control" placeholder="请输入手机号" required>
  212. <input style="width:36%;font-size: 10px;" class="btn btn-default" id="fasong" value="获取验证码" onclick="yanzhengma()"/>
  213. </div>
  214. <div id="yzma" class="col-xs-12 col-lg-4 input-group" style="margin:4px 0;display: none;">
  215. <input style="width: 100%;" type="text" name="yzma" class="form-control" placeholder="请输入验证码" required>
  216. </div>
  217. </div>
  218. <div class="danxuan">
  219. <label for="name">性别:</label>
  220. <div>
  221. <label class="checkbox-inline">
  222. <input name="sex" type="radio" value="nan" checked>男
  223. </label>
  224. <label class="checkbox-inline">
  225. <input name="sex" type="radio" value="nv">女
  226. </label>
  227. </div>
  228. <label for="name">样本类型:</label>
  229. <div class="checkbox">
  230. <label><input type="radio" value="l1" name="sample_type" checked>EDTA抗凝静脉血</label>
  231. </div>
  232. <div class="checkbox">
  233. <label><input type="radio" value="l2" name="sample_type">口腔拭子</label>
  234. </div>
  235. <div class="checkbox">
  236. <label><input type="radio" value="l3" name="sample_type">宫颈刷</label>
  237. </div>
  238. <button style="margin-left: 45%;margin-bottom: 20px;" type="button" onclick="tijiao()" class="btn btn-default">提交</button>
  239. </div>
  240. </div>
  241. <div id="tanchuang" style="display: none;">
  242. <div class="tanbox">
  243. <div style="width: 20px;height: 20px;text-align: center;position: absolute;top: -5px;right: -5px;background: #f04;border-radius: 20px;" onclick="closebox()">X</div>
  244. <div class="status b0">
  245. <text class="title">提交失败!!</text>
  246. <text style="font-size: 10px;color: #999;">请重新提交!!</text>
  247. </div>
  248. <div class="status b1">
  249. <text class="title">提交成功!!</text>
  250. <button class="btn btn-default" id="yeah" type="button" onclick="close(this)">下一页!</button>
  251. </div>
  252. <div class="status b2">
  253. <text class="title">下载****!!</text>
  254. <button class="btn btn-default" id="download" type="button" onclick="close(this)">下载!</button>
  255. </div>
  256. </div>
  257. </div>
  258. </form>
  259. </div>
  260. </div>
  261. <!-- jQuery (Bootstrap 的 JavaScript 插件需要引入 jQuery) -->
  262. <script src="{{cdn_asset('/assets/js/jquery-3.2.1.js')}}"></script>
  263. <script src="{{cdn_asset('/assets/js/bootstrap.min.js')}}"></script>
  264. </body>
  265. </html>