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43 lines
1.8 KiB
43 lines
1.8 KiB
6 months ago
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<!DOCTYPE html>
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<html lang="en">
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<head>
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<meta charset="UTF-8">
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<meta name="viewport" content="width=device-width, initial-scale=1.0">
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<title>确认挂号</title>
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<link rel="stylesheet" href="/static/css/confirmregistration.css">
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</head>
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<body>
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{% if message %}
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<p class="error">{{ message }}</p>
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{% endif %}
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{% if patient_name and doctor_name %}
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<h1>挂号确认</h1>
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<form method="post" >
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{% csrf_token %}
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<input type="hidden" name="doctor_id" value="{{ doctor_id }}">
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<input type="hidden" name="patient_id" value="{{ patient_id }}">
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<label for="patient_name">患者姓名：</label>
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<input type="text" id="patient_name" name="patient_name" value="{{ patient_name }}"><br>
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<label for="doctor_name">医生姓名：</label>
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<input type="text" id="doctor_name" name="doctor_name" value="{{ doctor_name }}"><br>
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<label for="registration_time">挂号时间：</label>
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<input type="text" id="registration_time" name="registration_time" value="{{ registration_time }}"><br>
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<label for="consultation_hour">预约时间：</label>
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<input type="text" id="consultation_hour" name="consultation_hour" value="{{ consultation_hour }}"><br>
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<label for="address">地址：</label>
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<input type="text" id="address" name="address" value="{{ address }}" placeholder="请输入地址"><br>
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<label for="registration_price">挂号费用：</label>
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<input type="number" id="registration_price" name="registration_price" step="0.01" value="{{ registration_price }}"><br>
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<label for="illness">病情：</label>
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<input type="text" id="illness" name="illness" placeholder="请输入病情">
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<button type="submit">确认挂号</button>
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<a href="/patientcenter/">返回</a>
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</form>
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{% endif %}
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</body>
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</html>
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