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<!DOCTYPE html>
<html>
	<head>
		<meta charset="utf-8">
		<meta name="viewport" content="width=device-width, initial-scale=1,maximum-scale=1,user-scalable=no">
		<meta content="yes" name="apple-mobile-web-app-capable">
		<meta content="black" name="apple-mobile-web-app-status-bar-style">
		<meta content="telephone=no" name="format-detection">
		<meta content="email=no" name="format-detection">
		<link rel="stylesheet" type="text/css" href="https://review-formal.iplusmed.com/Common/css/wechat_Reset.min.css" />
		<link rel="stylesheet" type="text/css" href="https://review-formal.iplusmed.com/Common/css/mui.picker.min.css" />
		<link rel="stylesheet" type="text/css" href="https://review-formal.iplusmed.com/Common/css/mui.min.css" />
		<link rel="stylesheet" type="text/css" href="../css/createPatientInfo.css" />
		<script src="https://review-formal.iplusmed.com/Common/javaScript/calRem.js" type="text/javascript" charset="utf-8"></script>
		<title>完善信息</title>
		<script src="https://review-formal.iplusmed.com/Common/javaScript/require.min.js"></script>
		<script type="text/javascript">
			require.config({
				baseUrl: "./",
				paths: {
					"zepto": "https://review-formal.iplusmed.com/Common/javaScript/zepto.min",
					"medtap": "https://review-formal.iplusmed.com/Common/javaScript/medtap_core_wx",
					"md5": "https://review-formal.iplusmed.com/Common/javaScript/md5.min",
					"mui": "https://review-formal.iplusmed.com/Common/javaScript/mui.min",
					"mui.picker": "https://review-formal.iplusmed.com/Common/javaScript/mui.picker.min"
				},
				shim: {
					"zepto": {
						exports: "$"
					},
					"mui.picker": ["mui"]
				}
			});
		</script>
	</head>
	<body>
		<div id="content">
			<div class="basic_header">
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				<p class="basic_title">完善患者信息
					<!-- <img src="../images/skip_butten_png@2x.png" class="skip"> -->
				</p>
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				<p class="basic_tip">为了便于医生提供准确的咨询建议，请尽量填写真实详尽的信息（填写的信息仅您和医生可见）</p>
			</div>
			<div class="input_list">
				<div class="input_item clearfix">
					<div class="left_tip">
						<span class="txt_red">*</span>
						<span class="input_tip">患者姓名</span>
					</div>
					<div class="right_box">
						<input type="text" name="" id="username" value="" placeholder="请输入真实姓名" />
					</div>
				</div>
				<div class="input_item clearfix">
					<div class="left_tip">
						<span class="txt_red">*</span>
						<span class="input_tip">性别</span>
					</div>
					<div class="right_box" id="sex_typeBox">
						<input type="text" name="" id="sex" value="" placeholder="请选择" readonly="true" />
						<img src="../images/_arrows _right@2x.png" class="arrow_icon">
					</div>
				</div>
				<div class="input_item clearfix">
					<div class="left_tip">
						<span class="txt_red">*</span>
						<span class="input_tip">出生日期</span>
					</div>
					<div class="right_box" id="birth_typeBox">
						<input type="text" name="" id="birth" value="" placeholder="请选择" readonly="true" />
						<img src="../images/_arrows _right@2x.png" class="arrow_icon">
					</div>
				</div>
				<div class="input_item clearfix">
					<div class="left_tip">
						<span class="input_tip">身高(cm)</span>
					</div>
					<div class="right_box">
						<input type="text" name="" id="height" value="" placeholder="请输入" />
					</div>
				</div>
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				<div class="input_item clearfix">
					<div class="left_tip">
						<span class="input_tip">体重(kg)</span>
					</div>
					<div class="right_box">
						<input type="text" name="" id="weight" value="" placeholder="请输入" />
					</div>
				</div>
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				<div class="input_item clearfix">
					<div class="left_tip">
						<span class="txt_red">*</span>
						<span class="input_tip">疾病诊断</span>
					</div>
					<div class="right_box" id="disease_typeBox">
						<input type="text" name="" id="disease" value="" placeholder="请选择" readonly="true" />
						<img src="../images/_arrows _right@2x.png" class="arrow_icon">
					</div>
				</div>
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				<div class="not_lung">
					<div class="input_item clearfix">
						<div class="left_tip">
							<span class="txt_red">*</span>
							<span class="input_tip">病理类型</span>
						</div>
						<div class="right_box" id="pathology_typeBox">
							<input type="text" name="" id="pathology" value="" placeholder="请选择" readonly="true" />
							<img src="../images/_arrows _right@2x.png" class="arrow_icon">
						</div>
					</div>
					<div class="input_item clearfix">
						<div class="left_tip">
							<span class="input_tip">肿瘤分期</span>
						</div>
						<div class="right_box" id="stages_typeBox">
							<input type="text" name="" id="stages" value="" placeholder="请选择" readonly="true" />
							<img src="../images/_arrows _right@2x.png" class="arrow_icon">
						</div>
					</div>
					<div class="input_item clearfix">
						<div class="left_tip">
							<span class="input_tip">TNM分期</span>
						</div>
						<div class="right_box" id="stages_TNM_typeBox">
							<input type="text" name="" id="stages_TNM" value="" placeholder="请选择" readonly="true" />
							<img src="../images/_arrows _right@2x.png" class="arrow_icon">
						</div>
					</div>
					<div class="input_item clearfix">
						<div class="left_tip">
							<span class="input_tip">有无转移病灶</span>
						</div>
						<div class="right_box" id="transfer_typeBox">
							<input type="text" name="" id="transfer" value="" placeholder="请选择" readonly="true" />
							<img src="../images/_arrows _right@2x.png" class="arrow_icon">
						</div>
					</div>
					<div class="input_item clearfix">
						<div class="left_tip">
							<span class="input_tip">有无吸烟史</span>
						</div>
						<div class="right_box somke_typeBox">
							<input type="text" name="" id="somke" value="" placeholder="请选择" readonly="true" />
							<img src="../images/_arrows _right@2x.png" class="arrow_icon">
						</div>
					</div>
					<div class="input_item clearfix">
						<div class="left_tip">
							<span class="input_tip">ECOG评分</span>
						</div>
						<div class="right_box" id="ECOG_typeBox">
							<input type="text" name="" id="ECOG" value="" placeholder="请选择" readonly="true" />
							<img src="../images/_arrows _right@2x.png" class="arrow_icon">
						</div>
					</div>
					<div class="input_item clearfix">
						<div class="left_tip" style="width:2.1rem;line-height:0.46rem;margin-left:0.2rem;">
							病案号/住院号医保卡号
						</div>
						<div class="right_box">
							<input type="text" name="" id="idCard" value="" placeholder="请输入" />
						</div>
					</div>
					<div class="input_item clearfix" style="border:none">
						<div class="left_tip">
							<span class="input_tip">医保所在地</span>
						</div>
						<div class="right_box" id="location_typeBox">
							<input type="text" name="" id="location" value="" placeholder="请选择" readonly="true" />
							<img src="../images/_arrows _right@2x.png" class="arrow_icon">
						</div>
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					</div>
				</div>
			</div>
		</div>
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		<!-- <div class="footer_btn hasPre">
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			<span class="pre">上一步</span>
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			<span class="next btnOn">下一步</span>
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		</div> -->
		<div class="footer_btn noPre btnOn" style="display:block">
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			下一步
		</div>
		<div class="content_mod">

		</div>
		<div class="somke_warp">
			<div class="somke_header">吸烟史</div>
			<div class="clearfix" style="padding-bottom:0.2rem;">
				<div class="somke_select yes" data-select="yes">
					<img src="../images/pop_select_active@2x.png">
					<span class="select_tip">吸烟</span>
				</div>
				<div class="somke_select no">
					<img src="../images/pop_select_default@2x.png">
					<span class="select_tip">不吸烟</span>
				</div>
			</div>
			<div class="somke_content">
				<div class="somke_content_item">
					<span class="txt_red">*</span>
					<span class="somke_content_item_leftTip">吸烟时长(年)</span>
					<input type="text" name="" value="" placeholder="请输入" id="somkeYear" onkeyup="value=value.replace(/[^\d]/g,'')" />
				</div>
				<div class="somke_content_item">
					<span class="txt_red">*</span>
					<span class="somke_content_item_leftTip">每日吸烟量(支)</span>
					<input type="text" name="" value="" placeholder="请输入" id="somkeNum" onkeyup="value=value.replace(/[^\d]/g,'')" />
				</div>
			</div>
			<div class="smoke_btn">确定</div>
		</div>
	</body>
	<script type="text/javascript">
		require(['../javaScript/createPatientInfo.js'])
	</script>
</html>