book_admin/application/admin/view/agreement/add.html

<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label for="c-username_a" class="control-label col-xs-12 col-sm-2">{:__('Username_a')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-username_a" maxlength="45" class="form-control" name="row[username_a]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label for="c-card_bank_a" class="control-label col-xs-12 col-sm-2">{:__('card_bank_a')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-card_bank_a" maxlength="45" class="form-control" name="row[card_bank_a]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label for="c-card_num_a" class="control-label col-xs-12 col-sm-2">{:__('card_num_a')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-card_num_a" maxlength="45" class="form-control" name="row[card_num_a]" type="text" value="">
        </div>
    </div>

    <div class="form-group">
        <label for="c-username_b" class="control-label col-xs-12 col-sm-2">{:__('Username_b')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-username_b" data-rule="required" maxlength="45" class="form-control" name="row[username_b]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label for="c-cardid_b" class="control-label col-xs-12 col-sm-2">{:__('Cardid_b')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-cardid_b" data-rule="required" maxlength="18" class="form-control" name="row[cardid_b]" type="text" value="">
        </div>
    </div>

    <div class="form-group">
        <label for="c-card_bank_b" class="control-label col-xs-12 col-sm-2">{:__('Card_bank_b')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-card_bank_b" data-rule="required" maxlength="18" class="form-control" name="row[card_bank_b]" type="text" value="">
        </div>
    </div>

    <div class="form-group">
        <label for="c-card_num_b" class="control-label col-xs-12 col-sm-2">{:__('Card_num_b')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-card_num_b" data-rule="required" maxlength="18" class="form-control" name="row[card_num_b]" type="text" value="">
        </div>
    </div>

    <div class="form-group">
        <label for="c-mobile_b" class="control-label col-xs-12 col-sm-2">{:__('Mobile_b')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-mobile_b" data-rule="required" class="form-control" maxlength="20" name="row[mobile_b]" type="text" value="">
        </div>
    </div>

    <!-- APPEND -->
    <div class="form-group">
        <label for="c-pay_shortname" class="control-label col-xs-12 col-sm-2">{:__('pay_shortname')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-pay_shortname" data-rule="required" class="form-control" maxlength="20" name="row[pay_shortname]" type="text" value="">
        </div>
    </div>

    <div class="form-group">
        <label for="c-settlement" class="control-label col-xs-12 col-sm-2">{:__('settlement')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-settlement" data-rule="required" class="form-control" maxlength="20" name="row[settlement]" type="text" value="" placeholder="例:10%:90%">
        </div>
    </div>
    <div class="form-group">
        <label for="c-start_year" class="control-label col-xs-12 col-sm-2">{:__('start_year')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-start_year" data-rule="required" class="form-control" maxlength="20" name="row[start_year]" type="text" value="" placeholder="2019">
        </div>
    </div>
    <div class="form-group">
        <label for="c-start_month" class="control-label col-xs-12 col-sm-2">{:__('start_month')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-start_month" data-rule="required" class="form-control" maxlength="20" name="row[start_month]" type="text" value="" placeholder="10">
        </div>
    </div>
    <div class="form-group">
        <label for="c-start_day" class="control-label col-xs-12 col-sm-2">{:__('start_day')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-start_day" data-rule="required" class="form-control" maxlength="20" name="row[start_day]" type="text" value="" placeholder="01">
        </div>
    </div>

    <div class="form-group">
        <label for="c-end_year" class="control-label col-xs-12 col-sm-2">{:__('end_year')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-end_year" data-rule="required" class="form-control" maxlength="20" name="row[end_year]" type="text" value="" placeholder="2020">
        </div>
    </div>
    <div class="form-group">
        <label for="c-end_month" class="control-label col-xs-12 col-sm-2">{:__('end_month')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-end_month" data-rule="required" class="form-control" maxlength="20" name="row[end_month]" type="text" value=""  placeholder="10">
        </div>
    </div>
    <div class="form-group">
        <label for="c-end_day" class="control-label col-xs-12 col-sm-2">{:__('end_day')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-end_day" data-rule="required" class="form-control" maxlength="20" name="row[end_day]" type="text" value="" placeholder="01">
        </div>
    </div>

    <div class="form-group">
        <label for="c-expiration_date" class="control-label col-xs-12 col-sm-2">{:__('expiration_date')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-expiration_date" data-rule="required" class="form-control" maxlength="20" name="row[expiration_date]" type="text" value="" placeholder="壹">
        </div>
    </div>
    <div class="form-group">
        <label for="c-template_type" class="control-label col-xs-12 col-sm-2">{:__('template_type')}:</label>
        <div class="col-xs-12 col-sm-8">
            <select class="form-control" id="c-template_type" name="row[template_type]" >
                <option value="1">模板一</option>
                <option value="2">模板二</option>
            </select>
        </div>
    </div>

    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>