?? rkxzl_edit.jsp.svn-base
字號:
<div align="right">戶口種類</div>
</td>
<td height="20" >
<div align="left">
<select name="HKZL">
<by:forby id="HKZL" name="DICT_HKZL">
<option value="${HKZL.NAME}" ${HKZL.NAME==rkxzlinfo_HKZL?'selected':''} >${HKZL.NAME}</option>
</by:forby>
</select>
</div>
</td>
<td height="20" class="TableColUp"><div align="right">民族</div></td>
<td height="20">
<div align="left"><select name="MZ">
<by:forby id="MZ" name="DICT_MZ">
<option value="${MZ.NAME}" ${MZ.NAME==rkxzlinfo_MZ?'selected':''} >${MZ.NAME }</option>
</by:forby>
</select></div>
</td>
</tr>
<tr align="center" valign="middle">
<td height="20" class="TableColUp">
<div align="right">身高</div>
</td>
<td height="20">
<div align="left">
<input type="text" name="SG" size=10 value="${rkxzlinfo_SG}"/>cm
</div>
</td>
<td height="20" class="TableColUp">
<div align="right">體重</div>
</td>
<td height="20">
<div align="left">
<input type="text" name="TZ" size=10 value="${rkxzlinfo_TZ }" />kg
</div>
</td>
<td height="20" class="TableColUp"><div align="right">血型</div></td>
<td height="20">
<div align="left"><select name="XX">
<by:forby id="XX" name="DICT_XX">
<option value="${XX.NAME}" ${XX.NAME==rkxzlinfo_XX?'selected':''} >${XX.NAME }</option>
</by:forby>
</select></div>
</td>
</tr>
<tr align="center" valign="middle">
<td height="20" class="TableColUp"><div align="right">婚姻狀況</div></td>
<td height="20">
<div align="left"><select name="HYZK">
<by:forby id="HYZK" name="DICT_HYZK">
<option value="${HYZK.NAME}" ${HYZK.NAME==rkxzlinfo_HYZK?'selected':''} >${HYZK.NAME}</option>
</by:forby>
</select></div>
</td>
</tr>
<tr align="center" valign="middle">
<td height="20" class="TableColUp"><div align="right">文化程度</div></td>
<td height="20">
<div align="left"><select name="WHCD">
<by:forby id="WHCD" name="DICT_WHCD">
<option value="${WHCD.NAME}" ${WHCD.NAME==rkxzlinfo_WHCD?'selected':''} >${WHCD.NAME}</option>
</by:forby>
</select></div>
</td>
<td height="20" class="TableColUp"><div align="right">職業狀況</div></td>
<td height="20">
<div align="left"><select name="ZY">
<by:forby id="ZY" name="DICT_ZY">
<option value="${ZY.NAME}" ${ZY.NAME==rkxzlinfo_ZY?'selected':''} >${ZY.NAME }</option>
</by:forby>
</select></div>
</td>
</tr>
<tr align="center" valign="middle">
<td height="20" class="TableColUp">
<div align="right">與戶主關系</div>
</td>
<td height="20">
<div align="left"><select name="YHZGX" onblur="pressYHZGX()">
<by:forby id="YHZGX" name="DICT_YHZGX">
<option value="${YHZGX.NAME}" ${YHZGX.NAME==rkxzlinfo_YHZGX?'selected':''} >${YHZGX.NAME }</option>
</by:forby>
</select></div>
</td>
<td height="20" class="TableColUp">
<div align="right">工作單位</div>
</td>
<td height="20" colspan="3">
<div align="left">
<input type="text" name="GZDW" size="50" value="${rkxzlinfo_GZDW }" /><font color="red"><strong>*</strong></font>
</div>
</td>
</tr>
<tr align="center" valign="middle">
<td height="20" class="TableColUp">
<div align="right">聯系電話</div>
</td>
<td height="20">
<div align="left">
<input type="text" name="LXDH" value="${rkxzlinfo_LXDH }" />
</div>
</td>
</tr>
<tr align="center" valign="middle">
<td height="20" class="TableColUp">
<div align="right">其他聯系方式</div>
</td>
<td height="20">
<div align="left">
<input type="text" name="QTLXFS" size="16" value="${rkxzlinfo_QTLXFS }" />
</div>
</td>
<td height="20" class="TableColUp">
<div align="right">醫保合同號</div>
</td>
<td height="20">
<div align="left">
<input type="text" name="YBHTH" size="16" value="${rkxzlinfo_YBHTH }" />
</div>
</td>
</tr>
<tr align="center" valign="middle">
<td height="20" class="TableColUp">
<div align="right">社會保險號</div>
</td>
<td height="20">
<div align="left">
<input type="text" name="SHBXH" value="${rkxzlinfo_SHBXH }" />
</div>
</td>
<td height="20" class="TableColUp" nowrap>
<div align="right">醫藥費用承擔</div>
</td>
<td height="20">
<div align="left">
<select name="YLFZFFS">
<by:forby id="YLFZFFS" name="DICT_YLFZFFS">
<option value="${YLFZFFS.NAME}" ${YLFZFFS.NAME==rkxzlinfo_YLFZFFS?'selected':''} >${YLFZFFS.NAME}</option>
</by:forby>
</select>
</div>
</td>
<td></td>
</tr>
<tr align="center" valign="middle">
<td height="20" class="TableColUp">
<div align="right">出潮年齡</div>
</td>
<td height="20">
<div align="left">
<input type="text" name="CCNL" size="5" value="${rkxzlinfo_CCNL }" />歲
</div>
</td>
<td height="20" class="TableColUp">
<div align="right">月經周期</div>
</td>
<td height="20">
<div align="left">
<input type="text" name="YJZQ" size=5 value="${rkxzlinfo_YJZQ }" />天
</div>
</td>
<td height="20" class="TableColUp">
<div align="right">末次月經</div>
</td>
<td height="20">
<div align="left">
<input type="text" name="MCYJ" size=5 value="${rkxzlinfo_MCYJ }" />歲
</div>
</td>
</tr>
<tr align="center" valign="middle">
<td height="20" class="TableColUp">
<div align="right">胎次</div>
</td>
<td height="20">
<div align="left">
<input type="text" name="TC" size=5 value="${rkxzlinfo_TC }" />次
</div>
</td>
<td height="20" class="TableColUp">
<div align="right">產次</div>
</td>
<td height="20">
<div align="left">
<input type="text" name="CC" size=5 value="${rkxzlinfo_CC}"/>次
</div>
</td>
<td height="20">
</td>
<td height="20">
<div align="left">
</div>
</td>
</tr>
<tr align="center" valign="middle">
<td height="20" align="right" class="TableColUp">
既往病史
</td>
<td height="20" colspan=5>
<div align="left">
<textarea cols="60" rows="5" name="JWBS" /> ${rkxzlinfo_JWBS }</textarea>
</div>
</td>
</tr>
<tr align="center" valign="middle">
<td height="20" class="TableColUp">
<div align="right">是否遷出</div>
</td>
<td><div align="left">
<select name="SFQC" onChange="QC();">
<option value="0" ${'0'==rkxzlinfo_SFQC?'selected':''} >否</option>
<option value="1" ${'1'==rkxzlinfo_SFQC?'selected':''} >是</option>
</select>
</div></td>
<td height="20" class="TableColUp">
<div align="right">遷出日期</div>
</td>
<td height="20">
<div align="left">
<input type="text" name="QCRQ" size="10" value="${rkxzlinfo_QCRQ }" onClick="show_cele_date(this,'','',this,'dcDate');">
</div>
</td>
<td height="20" class="TableColUp">
<div align="right">是否死亡</div>
</td>
<td><div align="left">
<select name="SFSW" onChange="SW();">
<option value="0" ${'0'==rkxzlinfo_SFSW?'selected':''} >否</option>
<option value="1" ${'1'==rkxzlinfo_SFSW?'selected':''} >是</option>
</select>
</div></td>
</tr>
<tr align="center" valign="middle">
<td class="TableColUp">
<div align="right">死亡日期</div>
</td>
<td>
<div align="left">
<input type="text" name="SWRQ" size="16" value="${rkxzlinfo_SWRQ }" onClick="show_cele_date(this,'','',this,'dcDate');">
</div>
</td>
<td class="TableColUp">
<div align="right">調查人員</div>
</td>
<td>
<div align="left">
<select name="DCRY">
<by:forby id="EMP" name="emp_list">
<option value="${EMP.NAME}"} ${EMP.NAME==rkxzlinfo_DCRY?'selected':''} >${EMP.NAME}</option>
</by:forby>
</select>
</div>
</td>
<td class="TableColUp">
<div align="right">調查日期</div>
</td>
<td>
<div align="left">
<input type="text" name="DCRQ" size="16" value="${rkxzlinfo_DCRQ }" onClick="show_cele_date(this,'','',this,'dcDate');"><font color="red"><strong>*</strong></font>
</div>
</td>
</tr>
<tr>
<td colspan="6"><div> </div></td>
</tr>
<tr>
<td colspan="6">
<div align="center">
<input type="submit" name="submit" value="保 存" class="button">
<input type="button" name="button" value="返 回" class="button" onClick="location.href='<%=path%>/Selevet.do?action=RKXZL_LIST'">
</div>
</td>
</tr>
</table>
</form>
</by:out>
</body>
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