You cannot select more than 25 topics
Topics must start with a letter or number, can include dashes ('-') and can be up to 35 characters long.
2 lines
106 KiB
Plaintext
2 lines
106 KiB
Plaintext
11 months ago
|
<p style="text-align: center;"><span style="font-family: 宋体, SimSun; font-size: 20px;"><strong><span leipiplugins="select" id="SS_MinZu" title="下拉框" name="leipiNewField" data-sftable="MinZu"></span>民族</strong></span></p><p style="text-align: center;"><span style="font-family: 宋体, SimSun; font-size: 20px;"><strong>困境儿童</strong></span></p><p><span style="font-family: 宋体, SimSun; font-size: 20px;"><strong>编号:</strong></span><input type="text" value="" id="TB_BillNo" name="TB_BillNo" data-key="BillNo" data-name="编号" data-type="Text" class="form-control" leipiplugins="text" style="width:120px"/></p><p><span style="font-family: 宋体, SimSun; font-size: 20px;"></span></p><center><table style="border: medium none; border-collapse: collapse;" data-sort="sortDisabled" width="-60"><tbody><tr class="firstRow"><th colspan="6" style="word-break: break-all;" width="989.0000000000001">儿童基本信息<br/></th><th colspan="1" style="word-break: break-all;" width="159"><br/></th><th colspan="1" style="word-break: break-all;" width="152.66666666666666"><br/></th></tr><tr><td style="word-break: break-all; text-align: center;" width="87" valign="top" height="49"><span style="font-size: 16px;"></span>儿童姓名 <br/></td><td style="word-break: break-all;" width="175" valign="top" height="49"><input type="text" value="" id="TB_UC_ETName" name="TB_UC_ETName" data-key="UC_ETName" data-name="儿童姓名" data-type="Text" class="form-control" leipiplugins="text" style="width:120px"/></td><td style="word-break: break-all;" width="153.66666666666666" valign="top" height="49"><span style="font-size: 16px;">身份证号</span> <br/></td><td style="word-break: break-all;" width="64" valign="top" height="49"><input type="text" value="" id="TB_UC_ETSFZ" name="TB_UC_ETSFZ" data-key="UC_ETSFZ" data-name="儿童身份证" data-type="Text" class="form-control" leipiplugins="text" style="width:120px" placeholder=""/></td><td style="word-break: break-all;" width="91.66666666666667" valign="top" height="40"><span style="font-size: 16px;"></span> 户籍状况</td><td style="word-break: break-all;" width="120.99999999999999" valign="top" height="20"><span leipiplugins="enum" style="margin-top:1px;display:block;" id="SR_UC_ETHuJi" title="单选" name="leipiNewField" data-key="UC_ETHuJi" data-type="Radio" data-bindkey="HuJi"><label style="vertical-align:middle;"><input type="radio" value="0" id="RB_UC_ETHuJi_0" name="RB_UC_ETHuJi" data-key="UC_ETHuJi" data-type="Radio" data-bindkey="HuJi" style="width:15px;height:15px;vertical-align:-1px;"/>农村社区 </label><label style="vertical-align:middle;"><input type="radio" value="1" id="RB_UC_ETHuJi_1" name="RB_UC_ETHuJi" data-key="UC_ETHuJi" data-type="Radio" data-bindkey="HuJi" style="width:15px;height:15px;vertical-align:-1px;"/>城市社区 </label></span></td><td style="word-break: break-all;" width="159" valign="top" height="20"><br/></td><td style="word-break: break-all;" width="152.66666666666666" valign="top" height="20"><br/></td></tr><tr><td style="word-break: break-all; text-align: center;" width="86" valign="top"> 性别 <br/></td><td style="word-break: break-all;" width="175" valign="top"><span leipiplugins="enum" id="SR_UC_ETXingBie" title="单选" name="leipiNewField" data-key="UC_ETXingBie" data-type="Radio"><label><input type="radio" value="0" id="RB_UC_ETXingBie_0" name="RB_UC_ETXingBie" data-key="UC_ETXingBie" data-type="Radio" data-bindkey="XingBie" style="width:15px;height:15px;"/>女</label> <label><input type="radio" value="1" id="RB_UC_ETXingBie_1" name="RB_UC_ETXingBie" data-key="UC_ETXingBie" data-type="Radio" data-bindkey="XingBie" style="width:15px;height:15px;"/>男</label><br/></span></td><td style="word-break: break-all;" width="153.66666666666666" valign="top"><span leipiplugins="select" id="SS_MinZu" title="下拉框" name="leipiNewField" data-sftable="MinZu"><span leipiplugins="select" id="SS_MinZu" title="下拉框" name="leipiNewField"
|
||
|
其它<br/></td><td colspan="7" rowspan="1" style="word-break: break-all;" valign="top"><input type="text" value="" id="TB_UC_JYQTSM" name="TB_UC_JYQTSM" data-key="UC_JYQTSM" data-name="教育其它情况说明" data-type="Text" class="form-control" leipiplugins="text" style="width: 40%;"/></td></tr><tr class="firstRow"><th colspan="6" style="word-break: break-all;" width="989.0000000000001">医疗救助情况<br/></th><th colspan="1" style="word-break: break-all;" width="159"><br/></th><th colspan="1" style="word-break: break-all;" width="82.66666666666666"><br/></th></tr><tr><td colspan="1" rowspan="1" style="word-break: break-all;" width="86" valign="top">基本医疗保险<br/></td><td colspan="2" rowspan="1" style="word-break: break-all;" valign="top"><span leipiplugins="enum" id="SR_UC_YLBXQK" title="单选" name="leipiNewField" data-key="UC_YLBXQK" data-type="Radio"><label><input type="radio" value="0" id="RB_UC_YLBXQK_0" name="RB_UC_YLBXQK" data-key="UC_YLBXQK" data-type="Radio" data-bindkey="YLBX" style="width:15px;height:15px;"/>政府资助参保</label> <label><input type="radio" value="1" id="RB_UC_YLBXQK_1" name="RB_UC_YLBXQK" data-key="UC_YLBXQK" data-type="Radio" data-bindkey="YLBX" style="width:15px;height:15px;"/>自费参保</label> <label><input type="radio" value="2" id="RB_UC_YLBXQK_2" name="RB_UC_YLBXQK" data-key="UC_YLBXQK" data-type="Radio" data-bindkey="YLBX" style="width:15px;height:15px;"/>未参保</label> </span></td><td colspan="1" rowspan="1" width="68" valign="top"><br/></td><td colspan="1" rowspan="1" width="91.66666666666667" valign="top"><br/></td><td colspan="1" rowspan="1" width="120.99999999999999" valign="top"><br/></td><td colspan="1" rowspan="1" width="159" valign="top"><br/></td><td colspan="1" rowspan="1" width="82.66666666666666" valign="top"><br/></td></tr><tr><td colspan="1" rowspan="1" style="word-break: break-all;" width="86" valign="top">商业意外保险<br/></td><td colspan="2" rowspan="1" style="word-break: break-all;" valign="top"><span leipiplugins="enum" id="SR_UC_SYBXQK" title="单选" name="leipiNewField" data-key="UC_SYBXQK" data-type="Radio"><label><input type="radio" value="0" id="RB_UC_SYBXQK_0" name="RB_UC_SYBXQK" data-key="UC_SYBXQK" data-type="Radio" data-bindkey="YLBX" style="width:15px;height:15px;"/>政府资助参保</label> <label><input type="radio" value="1" id="RB_UC_SYBXQK_1" name="RB_UC_SYBXQK" data-key="UC_SYBXQK" data-type="Radio" data-bindkey="YLBX" style="width:15px;height:15px;"/>自费参保</label> <label><input type="radio" value="2" id="RB_UC_SYBXQK_2" name="RB_UC_SYBXQK" data-key="UC_SYBXQK" data-type="Radio" data-bindkey="YLBX" style="width:15px;height:15px;"/>未参保</label> </span></td><td colspan="1" rowspan="1" width="68" valign="top"><br/></td><td colspan="1" rowspan="1" width="91.66666666666667" valign="top"><br/></td><td colspan="1" rowspan="1" width="120.99999999999999" valign="top"><br/></td><td colspan="1" rowspan="1" width="159" valign="top"><br/></td><td colspan="1" rowspan="1" width="82.66666666666666" valign="top"><br/></td></tr><tr><td colspan="1" rowspan="1" style="word-break: break-all;" width="86" valign="top">病患救助情况<br/></td><td colspan="2" rowspan="1" valign="top"><span leipiplugins="enum" id="SR_UC_BHJZQK" title="单选" name="leipiNewField" data-key="UC_BHJZQK" data-type="Radio"><label><input type="radio" value="0" id="RB_UC_BHJZQK_0" name="RB_UC_BHJZQK" data-key="UC_BHJZQK" data-type="Radio" data-bindkey="BHJZ" style="width:15px;height:15px;"/>大病慈善救助</label> <label><input type="radio" value="1" id="RB_UC_BHJZQK_1" name="RB_UC_BHJZQK" data-key="UC_BHJZQK" data-type="Radio" data-bindkey="BHJZ" style="width:15px;height:15px;"/>明天计划</label> <label><input type="radio" value="2" id="RB_UC_BHJZQK_2" name="RB_UC_BHJZQK" data-key="UC_BHJZQK" data-type="Radio" data-bindkey="BHJZ" style="width:15px;height:15px;"/>其它</label> </span></td><td colspan="3" rowspan="1" style="word-break: break-
|