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- <view class="main data-v-32bd6cac"><form class="data-v-32bd6cac"><view class="cu-form-group margin-top data-v-32bd6cac"><view class="title data-v-32bd6cac">头像</view><image class="cu-avatar radius bg-gray data-v-32bd6cac" src="{{imgList[0]}}" mode="aspectFill" data-event-opts="{{[['tap',[['ChooseImage',['$event']]]]]}}" bindtap="__e"></image></view><view class="cu-form-group data-v-32bd6cac"><view class="title data-v-32bd6cac">就诊人姓名:</view><input placeholder-style="text-align:right" placeholder="请输入姓名" data-event-opts="{{[['input',[['__set_model',['','name','$event',[]]]]]]}}" value="{{name}}" bindinput="__e" class="data-v-32bd6cac"/></view><view class="cu-form-group data-v-32bd6cac"><view class="title data-v-32bd6cac">就诊人性别:</view><u-radio-group bind:change="__e" bind:input="__e" vue-id="0c53f382-1" value="{{value}}" data-event-opts="{{[['^change',[['radioGroupChange']]],['^input',[['__set_model',['','value','$event',[]]]]]]}}" class="data-v-32bd6cac" bind:__l="__l" vue-slots="{{['default']}}"><block wx:for="{{list}}" wx:for-item="item" wx:for-index="index" wx:key="index"><u-radio vue-id="{{('0c53f382-2-'+index)+','+('0c53f382-1')}}" name="{{item.name}}" disabled="{{item.disabled}}" class="data-v-32bd6cac" bind:__l="__l" vue-slots="{{['default']}}">{{''+item.name+''}}</u-radio></block></u-radio-group></view><view class="cu-form-group data-v-32bd6cac"><view class="title data-v-32bd6cac">出身年月:</view><picker mode="date" value="{{date}}" data-event-opts="{{[['change',[['bindDateChange',['$event']]]]]}}" bindchange="__e" class="data-v-32bd6cac"><view class="picker data-v-32bd6cac">{{''+date+''}}</view></picker></view><view data-event-opts="{{[['tap',[['e0',['$event']]]]]}}" class="cu-form-group data-v-32bd6cac" bindtap="__e"><view class="title data-v-32bd6cac">与就诊人关系:</view><picker value="{{guanxi}}" range="{{guanxilist}}" range-key="label" data-event-opts="{{[['change',[['confirm',['$event']]]]]}}" bindchange="__e" class="data-v-32bd6cac"><view class="picker data-v-32bd6cac">{{''+guanxi+''}}</view></picker></view><view class="cu-form-group margin-top data-v-32bd6cac"><view class="title data-v-32bd6cac">就诊信息(非必填)</view></view><view class="cu-form-group data-v-32bd6cac"><view class="title data-v-32bd6cac">就诊人身份证:</view><input placeholder-style="text-align:right" placeholder="请输入就诊人身份证号" data-event-opts="{{[['input',[['__set_model',['','idcrad','$event',[]]]]]]}}" value="{{idcrad}}" bindinput="__e" class="data-v-32bd6cac"/></view><view class="padding-sm bg-white data-v-32bd6cac" style="color:#C0C0C0;">注：就诊人信息用于平台审核和医疗业务使用，不会外传。请正却确填写就诊人信息，如需修改身份信息可电话联系客服修改（13330431369）</view></form><view class="cu-bar bg-white tabbar data-v-32bd6cac" style="position:fixed;bottom:0;width:100%;"><view data-event-opts="{{[['tap',[['addarchives',['$event']]]]]}}" class="submit data-v-32bd6cac" style="background-color:#0B73B9;color:white;" bindtap="__e">提交</view></view></view>
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