<!DOCTYPE html>
<html>
<head>
<meta charset="UTF-8">
<title>Insert title here</title>
<link rel="stylesheet" href="css/bootstrap.min.css">
<link rel="stylesheet" href="css/dxh.css">
</head>
<body>
<div class="container-fluid no-mp">
<nav class="navbar navbar-default">
<div class="container-fluid no-mp">
<div class="collapse navbar-collapse">
<ul class="nav navbar-nav nav-header">
<li><a href="#">门诊挂号管理</a></li><li class="right">|</li>
<li><a href="#">门诊收费管理</a></li><li class="right">|</li>
<li><a href="#">住院登记管理</a></li><li class="right">|</li>
<li><a href="#">住院费用管理</a></li><li class="right">|</li>
<li><a href="#">医院字典设定</a></li><li class="right">|</li>
<li><a href="#">个人设置</a></li>
</ul>
</div>
</div>
</nav>
<div class="row" style="margin-left: 0; height: 44px; line-height: 44px;">
<form class="form-inline" style="color: #3670ab; font-size: 12px;">
<div class="form-group" style="margin-right: 4px;">
<label for="exampleInputName2" style="margin-right: 4px;">门诊挂号发票</label>
<input type="text" class="form-control" style="margin: 0;" id="exampleInputName2" placeholder="">
</div>
更新发票号
</form>
</div>
<div class="row" style="height: 40px;background-color: #ebf1f5;">
<div style="padding-left: 26px;color: #4b7423; font-size: 12px; height: 40px; line-height: 40px; float: left;" >挂号信息</div>
<div style="float: right; margin-right: 15px;" class="function-icon">
<span class="glyphicon glyphicon-refresh"></span>
<span style="margin-left: 8px;">清屏</span>
</div>
<div style="float: right;" class="function-icon">
<span class="glyphicon glyphicon-file"></span>
<span style="margin-left: 8px;">退号</span>
</div>
<div style="float: right;" class="function-icon">
<span class="glyphicon glyphicon-align-justify"></span>
<span style="margin-left: 8px;">退费</span>
</div>
</div>
<div class="row" style="height: 28px; background-color: #dce9f2;border-top: 1px solid white;box-sizing: border-box;">
<form class="form-inline">
<div class="form-group" style="margin-left: 16px; width: 80px; height: 26px; box-sizing: border-box; line-height: 26px; font-size: 0;">
<button class="btn btn-default dropdown-toggle" type="button" id="dropdownMenu1" data-toggle="dropdown" aria-haspopup="true" aria-expanded="true"
style="padding: 0 12px;font-size: 12px; height: 25px; border-radius: 0;"
>
身份证号
<span class="caret"></span>
</button>
</div>
<div class="form-group" style="margin-left: 4px;">
<input type="text" class="form-control" style="width: 174px;margin: 0; border-radius: 0;height: 25px;">
</div>
<div class="form-group" style="margin-left: 4px;vertical-align: middle;font-size: 12px;">
<span class="glyphicon glyphicon-credit-card" style="top: 2px;color: #173e70"></span>
<span style="color: #333333;">医保卡读卡</span>
</div>
<div class="form-group" style="margin-left: 4px;vertical-align: middle;font-size: 12px;">
<span class="glyphicon glyphicon-credit-card" style="top: 2px;color: #173e70"></span>
<span style="color: #333333;">农合卡读卡</span>
</div>
<div class="form-group" style="margin-left: 4px;vertical-align: middle;font-size: 12px;">
<span class="glyphicon glyphicon-credit-card" style="top: 2px;color: #173e70"></span>
<span style="color: #333333;">身份证读卡</span>
</div>
<div class="form-group" style="margin-left: 4px;vertical-align: middle;font-size: 12px;">
<span class="glyphicon glyphicon-credit-card" style="top: 2px;color: #173e70"></span>
<span style="color: #333333;">健康卡读卡</span>
</div>
<div class="form-group" style="margin-left: 4px;vertical-align: middle;font-size: 12px;">
<span class="glyphicon glyphicon-credit-card" style="top: 2px;color: #173e70"></span>
<span style="color: #333333;">熙康卡读卡</span>
</div>
</form>
</div>
<div class="row" style="padding-left: 16px; padding-bottom: 38px; background-color: #ffffff;" >
<form class="form-inline">
<div class="form-group">
<label for="e1" class="singleLabel">病例号</label>
<input type="text" class="form-control singleLine" id="e1">
</div>
<div class="form-group">
<label for="e1" class="singleLabel">姓名</label>
<input type="text" class="form-control singleLine" id="e1">
</div>
<div class="form-group">
<label for="e1" class="singleLabel">性别</label>
<input type="text" class="form-control singleLine" id="e1">
</div>
<div class="form-group">
<label for="e1" class="singleLabel">年龄</label>
<input type="text" class="form-control singleLine" id="e1">
</div>
<div class="form-group">
<label for="e1" class="singleLabel">出生日期</label>
<input type="text" class="form-control singleLine" id="e1">
</div>
<div class="form-group">
<label for="e1" class="singleLabel">结算类型</label>
<input type="text" class="form-control singleLine" id="e1">
</div>
<div class="form-group">
<label for="e1" class="singleLabel">医疗证书</label>
<input type="text" class="form-control singleLine" id="e1">
</div>
<div class="form-group">
<label for="e1" class="singleLabel">医疗类别</label>
<input type="text" class="form-control singleLine" id="e1">
</div>
<div class="form-group">
<label for="e1" class="singleLabel">身份证号</label>
<input type="text" class="form-control singleLine" id="e1">
</div>
<div class="form-group">
<label for="e1" class="singleLabel">家庭住址</label>
<input type="text" class="form-control singleLine" id="e1">
</div>
<div class="form-group">
<label for="e1" class="singleLabel">发票号</label>
<input type="text" class="form-control singleLine" id="e1">
</div>
</form>
</div>
<div class="row row-no-gutters" style="background-color: #ffffff;border-top: 1px solid #dfdfdf" >
<div class="col-md-6 col-lg-6 col-xs-6 col-sm-6" style="height: 344px;">
<div style="height: 35px; background-color: #ebf1f5; color: #4b7423;line-height: 35px; padding-left: 44px; border: 1px solid #dfdfdf;">挂号信息列表</div>
<table class="table table-bordered" style="padding-left: 16px; text-align: center">
<thead>
<tr>
<td></td>
<td>病例号</td>
<td>姓名</td>
<td>性别</td>
<td>出生日期</td>
<td>身份证号</td>
<td>发票号</td>
<td>结算类别</td>
</tr>
</thead>
</table>
<nav aria-label="Page navigation" class="nav-default">
<ul class="pagination">
<li>
<a href="#" aria-label="Previous">
<span aria-hidden="true">«</span>
</a>
</li>
<li><a href="#">1</a></li>
<li>
<a href="#" aria-label="Next">
<span aria-hidden="true">»</span>
</a>
</li>
</ul>
</nav>
</div>
<div class="col-md-6 col-lg-6 col-xs-6 col-sm-6" style="padding: 0;">
<div style="height: 35px; background-color: #ebf1f5; color: #4b7423;line-he
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WEB 练手 TEST TEST TEST
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