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

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

    <div class="form-group">
        <label for="c-order_id" class="control-label col-xs-12 col-sm-2">{:__('Order_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-order_id" data-rule="required" data-source="order/index" class="form-control selectpage" name="row[order_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label for="c-dz_palmpay_sub_account_id" class="control-label col-xs-12 col-sm-2">{:__('Dz_palmpay_sub_account_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-dz_palmpay_sub_account_id" data-rule="required" data-source="dz/palmpay/sub/account/index" class="form-control selectpage" name="row[dz_palmpay_sub_account_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label for="c-dz_amount" class="control-label col-xs-12 col-sm-2">{:__('Dz_amount')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-dz_amount" data-rule="required" class="form-control" step="0.01" name="row[dz_amount]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label for="c-channel_palmpay_sub_account_id" class="control-label col-xs-12 col-sm-2">{:__('Channel_palmpay_sub_account_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-channel_palmpay_sub_account_id" data-rule="required" data-source="channel/palmpay/sub/account/index" class="form-control selectpage" name="row[channel_palmpay_sub_account_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label for="c-channel_amount" class="control-label col-xs-12 col-sm-2">{:__('Channel_amount')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-channel_amount" data-rule="required" class="form-control" step="0.01" name="row[channel_amount]" type="number">
        </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>