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- <view class="cnt_wrapper data-v-992851c0"><view class="add_wrap data-v-992851c0"><form data-event-opts="{{[['submit',[['formSubmit',['$event']]]]]}}" bindsubmit="__e" class="data-v-992851c0"><view class="uni-form-item uni-column data-v-992851c0"><view class="title required data-v-992851c0">关系</view><view class="uni-list-cell-db data-v-992851c0"><picker value="{{index}}" range="{{array}}" data-event-opts="{{[['change',[['bindPickerChange',['$event']]]]]}}" bindchange="__e" class="data-v-992851c0"><view class="uni-input data-v-992851c0">{{array[index]+''}}<van-icon vue-id="8be0e434-1" name="arrow-down" class="data-v-992851c0" bind:__l="__l"></van-icon></view></picker></view></view><view class="uni-form-item uni-column data-v-992851c0"><view class="title required data-v-992851c0">身份证号</view><view class="uni-form-item uni-column data-v-992851c0"><input class="uni-input data-v-992851c0" type="idcard" required="required" maxlength="18" name="input" placeholder="请输入就诊人身份证卡号" data-event-opts="{{[['input',[['__set_model',['','standing_ID','$event',[]]]]]]}}" value="{{standing_ID}}" bindinput="__e"/></view></view><view class="uni-form-item uni-column data-v-992851c0"><view class="title required data-v-992851c0">姓名</view><view class="uni-form-item uni-column data-v-992851c0"><input class="uni-input data-v-992851c0" required="required" name="input" placeholder="请输入就诊人姓名" data-event-opts="{{[['input',[['__set_model',['','client_name','$event',[]]]]]]}}" value="{{client_name}}" bindinput="__e"/></view></view><view class="uni-form-item uni-column data-v-992851c0"><view class="title data-v-992851c0">住址</view><view class="uni-form-item uni-column data-v-992851c0"><input class="uni-input data-v-992851c0" name="input" placeholder="请输入住址" data-event-opts="{{[['ch',[['',['$event']]]],['input',[['__set_model',['','address','$event',[]]]]]]}}" value="{{address}}" bindch="__e" bindinput="__e"/></view></view><view class="divedeline data-v-992851c0"></view><view class="uni-form-item uni-column data-v-992851c0" style="padding-right:0px;width:652rpx;"><view class="title data-v-992851c0">手机号码</view><view class="uni-form-item uni-column data-v-992851c0" style="padding:0rpx;"><input class="uni-input data-v-992851c0" name="input" placeholder="请输入您的手机号码" data-event-opts="{{[['input',[['__set_model',['','mobile','$event',[]]]]]]}}" value="{{mobile}}" bindinput="__e"/><view data-event-opts="{{[['tap',[['getcode',['$event']]]]]}}" class="getCode data-v-992851c0" bindtap="__e">获取验证码</view></view></view><view class="uni-form-item uni-column data-v-992851c0"><view class="title data-v-992851c0">验证码</view><view class="uni-form-item uni-column data-v-992851c0"><input class="uni-input data-v-992851c0" name="input" placeholder="请输入验证码" data-event-opts="{{[['input',[['__set_model',['','code','$event',[]]]]]]}}" value="{{code}}" bindinput="__e"/></view></view><view class="divedeline data-v-992851c0"></view><view class="uni-btn-v data-v-992851c0"><button form-type="submit" class="data-v-992851c0">立即绑定</button></view></form></view><view class="data-v-992851c0"></view><van-toast vue-id="8be0e434-2" id="van-toast" data-com-type="wx" class="data-v-992851c0" bind:__l="__l"></van-toast></view>
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