yjyf/server/application/admin/view/withdraw/edit.html

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

    <!-- 1. 提现主体与资金明细 -->
    <div class="panel panel-default panel-form-section">
        <div class="panel-heading">
            <h4 class="panel-title"><i class="fa fa-cny"></i> 提现主体与金额明细</h4>
        </div>
        <div class="panel-body">
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">{:__('Master_id')}:</label>
                <div class="col-xs-12 col-sm-10">
                    <input id="c-master_id" data-rule="required" min="0" data-source="master/index" class="form-control selectpage" name="row[master_id]" type="text" value="{$row.master_id|htmlentities}">
                </div>
            </div>

            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">提现款项明细:</label>
                <div class="col-xs-12 col-sm-10">
                    <div class="row">
                        <div class="col-xs-4">
                            <div class="input-group">
                                <span class="input-group-addon">申请额 ¥</span>
                                <input id="c-amount" data-rule="required" class="form-control" step="0.01" name="row[amount]" type="number" value="{$row.amount|htmlentities}">
                            </div>
                        </div>
                        <div class="col-xs-4">
                            <div class="input-group">
                                <span class="input-group-addon">手续费 ¥</span>
                                <input id="c-fee" data-rule="required" class="form-control" step="0.01" name="row[fee]" type="number" value="{$row.fee|htmlentities}">
                            </div>
                        </div>
                        <div class="col-xs-4">
                            <div class="input-group">
                                <span class="input-group-addon">到账额 ¥</span>
                                <input id="c-arrive_amount" data-rule="required" class="form-control" step="0.01" name="row[arrive_amount]" type="number" value="{$row.arrive_amount|htmlentities}">
                            </div>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>

    <!-- 2. 结算账户 -->
    <div class="panel panel-default panel-form-section">
        <div class="panel-heading">
            <h4 class="panel-title"><i class="fa fa-credit-card"></i> 结算渠道与到账账户</h4>
        </div>
        <div class="panel-body">
            <div class="row">
                <div class="col-xs-12 col-sm-6">
                    <div class="form-group">
                        <label class="control-label col-xs-12 col-sm-4">{:__('Channel')}:</label>
                        <div class="col-xs-12 col-sm-8">
                            <select id="c-channel" data-rule="required" class="form-control selectpicker" name="row[channel]">
                                {foreach name="channelList" item="vo"}
                                    <option value="{$key}" {in name="key" value="$row.channel"}selected{/in}>{$vo}</option>
                                {/foreach}
                            </select>
                        </div>
                    </div>
                </div>
                <div class="col-xs-12 col-sm-6">
                    <div class="form-group">
                        <label class="control-label col-xs-12 col-sm-4">{:__('Account')}:</label>
                        <div class="col-xs-12 col-sm-8">
                            <input id="c-account" data-rule="required" class="form-control" name="row[account]" type="text" value="{$row.account|htmlentities}">
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>

    <!-- 3. 审核状态 -->
    <div class="panel panel-default panel-form-section">
        <div class="panel-heading">
            <h4 class="panel-title"><i class="fa fa-check-square-o"></i> 财务审核与批注</h4>
        </div>
        <div class="panel-body">
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">{:__('Status')}:</label>
                <div class="col-xs-12 col-sm-10">
                    <div class="radio">
                    {foreach name="statusList" item="vo"}
                    <label for="row[status]-{$key}"><input id="row[status]-{$key}" name="row[status]" type="radio" value="{$key}" {in name="key" value="$row.status"}checked{/in} /> {$vo}</label> 
                    {/foreach}
                    </div>
                </div>
            </div>

            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">{:__('Audit_msg')}:</label>
                <div class="col-xs-12 col-sm-10">
                    <input id="c-audit_msg" class="form-control" name="row[audit_msg]" type="text" value="{$row.audit_msg|htmlentities}">
                </div>
            </div>
        </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-primary btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>