- <view class="content"><view class="inner"><u-alert wx:if="{{a}}" u-i="0a9339af-0" bind:__l="__l" u-p="{{a}}"></u-alert><view class="form-box"><view class="form-item"><text class="label">姓名</text><input class="input-width" type="text" placeholder="请输入真实姓名" placeholder-class="form-input" value="{{b}}" bindinput="{{c}}"/></view><view class="form-item"><text class="label">性别</text><radio-group style="display:flex;align-items:center"><label style="margin-right:30rpx"><radio bindtap="{{d}}" color="#C39A58" value="1" checked="{{e}}" style="margin-right:16upx"/><text class="option-text">男</text></label><label><radio bindtap="{{f}}" color="#C39A58" value="2" checked="{{g}}" style="margin-right:16upx"/><text class="option-text">女</text></label></radio-group></view><view class="form-item"><text class="label">联系方式</text><input class="input-width" type="phone" placeholder="请输入联系方式" placeholder-class="form-input" value="{{h}}" bindinput="{{i}}"/></view><view class="form-item"><text class="label">身份证号</text><input class="input-width" type="idcard" bindblur="{{j}}" placeholder="请输入身份证号" placeholder-class="form-input" value="{{k}}" bindinput="{{l}}"/></view><view class="form-item"><text class="label">出生年月</text><picker value="{{n}}" start="1900-01-01" class="birth-picker" mode="date" bindchange="{{o}}"><view class="right-box"><view class="input-box"><input type="text" value="{{m}}" placeholder="请选择出生年月" placeholder-class="form-input" disabled="disabled"/></view><image class="arrow" src="/static/images/arrow_gray.png" mode=""></image></view></picker></view></view><view class="form-box"><view class="form-item" bindtap="{{q}}"><text class="label">与本人关系</text><view class="right-box"><view class="input-box"><input type="text" value="{{p}}" placeholder="请选择" placeholder-class="form-input" disabled="disabled"/></view><image class="arrow" src="/static/images/arrow_gray.png" mode=""></image></view></view></view><view class="form-box"><view class="form-item"><text class="label">肝功能</text><radio-group bindchange="{{t}}" style="display:flex;align-items:center"><label style="margin-right:30rpx"><radio color="#C39A58" value="正常" checked="{{r}}" style="margin-right:16upx"/><text class="option-text">正常</text></label><label><radio color="#C39A58" value="异常" checked="{{s}}" style="margin-right:16upx"/><text class="option-text">异常</text></label></radio-group></view><view class="form-item"><text class="label">肾功能</text><radio-group bindchange="{{x}}" style="display:flex;align-items:center"><label style="margin-right:30rpx"><radio color="#C39A58" value="正常" checked="{{v}}" style="margin-right:16upx"/><text class="option-text">正常</text></label><label><radio color="#C39A58" value="异常" checked="{{w}}" style="margin-right:16upx"/><text class="option-text">异常</text></label></radio-group></view><view class="form-item"><text class="label">过敏史</text><radio-group bindchange="{{A}}" style="display:flex;align-items:center;justify-content:flex-end;margin:5rpx 0rpx"><label style="margin-right:30rpx"><radio color="#C39A58" value="无" checked="{{y}}" style="margin-right:16upx"/><text class="option-text">无</text></label><label><radio color="#C39A58" value="有" checked="{{z}}" style="margin-right:16upx"/><text class="option-text">有</text></label></radio-group></view><view wx:if="{{B}}" class="form-item"><view class="option-box" style="margin:5rpx 0rpx"><view wx:for="{{C}}" wx:for-item="item" class="option"><u-tag wx:if="{{item.c}}" bindclick="{{item.a}}" u-i="{{item.b}}" bind:__l="__l" u-p="{{item.c}}"></u-tag></view></view></view><view class="form-item"><text class="label">个人病史</text><radio-group bindchange="{{F}}" style="display:flex;align-items:center"><label style="margin-right:30rpx"><radio color="#C39A58" value="无" checked="{{D}}" style="margin-right:16upx"/><text class="option-text">无</text></label><label><radio color="#C39A58" value="有" checked="{{E}}" style="margin-right:16upx"/><text class="option-text">有</text></label></radio-group></view><view wx:if="{{G}}" class="form-item"><view class="option-box" style="margin:5rpx 0rpx"><view wx:for="{{H}}" wx:for-item="item" class="option"><u-tag wx:if="{{item.c}}" bindclick="{{item.a}}" u-i="{{item.b}}" bind:__l="__l" u-p="{{item.c}}"></u-tag></view></view></view><view class="form-item"><text class="label">家庭病史</text><radio-group bindchange="{{K}}" style="display:flex;align-items:center"><label style="margin-right:30rpx"><radio color="#C39A58" value="无" checked="{{I}}" style="margin-right:16upx"/><text class="option-text">无</text></label><label><radio color="#C39A58" value="有" checked="{{J}}" style="margin-right:16upx"/><text class="option-text">有</text></label></radio-group></view><view wx:if="{{L}}" class="form-item"><view class="option-box" style="margin:5rpx 0rpx"><view wx:for="{{M}}" wx:for-item="item" class="option"><u-tag wx:if="{{item.c}}" bindclick="{{item.a}}" u-i="{{item.b}}" bind:__l="__l" u-p="{{item.c}}"></u-tag></view></view></view></view></view><view class="btn-box"><view class="sub-btn" bindtap="{{N}}">保存就诊人</view></view><u-action-sheet wx:if="{{Q}}" bindclose="{{O}}" bindselect="{{P}}" u-i="0a9339af-4" bind:__l="__l" u-p="{{Q}}"></u-action-sheet></view>
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