<!--pages/fnSubscribeDocument/fnSubscribeDocument.wxml 妇女婚检建档-->
<form catchsubmit="formSubmit">
<view class="subscribeDocument">
<view class="tip">为了医院给您更好的婚检，请按照实际信息填写资料</view>
<!--<view class="topBar">
<view class="topBar-left lightHight"></view>
<view class="topBar-right"></view>
<view class="topBar-right"></view>
</view>
<view class="title">
<image src="../../source/imageSource/page17_icon_woman_n@3x.png"></image>
<text>孕妇基本信息</text>
</view>-->
<!-- <ocr-navigator bind:onSuccess="getCard" certificateType="idCard" opposite="{{false}}">
<view style="width: 140px;text-align: center;background:#ee7289;color: white;line-height: 35px;font-size: 14px;border-radius: 5px;margin-left: 4%;margin-top: 15px;">身份证正面识别</view>
<text style="font-size: 14px;margin-left: 4%;color: #ee7289;">识别身份证信息，自动将身份信息填入下面表单。</text>
</ocr-navigator> -->
<view class="input {{mustInputData.must_name?'mustFillIn':''}}">
<text>姓名</text>
<input name="username" bindinput='inputText' data-ids='username' maxlength="12" placeholder="请填写您的姓名" placeholder-class="input-placeholder" value='{{defaultInfo.username ? defaultInfo.username : ""}}'/>
</view>
<view class="nationalityNational">
<view class="input nationality {{mustInputData.must_sex?'mustFillIn':''}}">
<text>性别</text>
<picker name="sex" class="picker" bindchange="bindSex" value="{{sexIndex}}" range="{{sexList}}" range-key="name">
<view class="picker__text">
{{sex ? sex.name: '请选择性别'}}
</view>
<image src="../../source/imageSource/page17_icon_triangle_n@3x.png" class="picker__right">
</image>
</picker>
</view>
<view class="input national {{mustInputData.must_marriage?'mustFillIn':''}}" >
<text>婚姻状况</text>
<picker name="marriageId" class="picker" bindchange="bindMarriage" range="{{marriageStatus}}" range-key="name">
<view class="picker__text">
{{marriageId ? marriageId.name: '请选择婚姻状况'}}
</view>
<image src="../../source/imageSource/page17_icon_triangle_n@3x.png" class="picker__right">
</image>
</picker>
</view>
</view>
<view class="nationalityNational">
<view class="input nationality {{mustInputData.must_nationality?'mustFillIn':''}}">
<text>国籍</text>
<picker name="nationality" class="picker" bindchange="bindPickerNationality" value="{{index}}" range="{{nationality}}" range-key="name">
<view class="picker__text">
{{nationalityEntity.name}}
</view>
<image src="../../source/imageSource/page17_icon_triangle_n@3x.png" class="picker__right">
</image>
</picker>
</view>
<view class="input national {{mustInputData.must_national?'mustFillIn':''}}">
<text>民族</text>
<picker name="nation" class="picker" bindchange="bindPickerNational" value="{{nationalIndex}}" range="{{national}}" range-key="name">
<view class="picker__text">
{{nationalEntity.name}}
</view>
<image src="../../source/imageSource/page17_icon_triangle_n@3x.png" class="picker__right">
</image>
</picker>
</view>
</view>
<view class="input {{mustInputData.must_birthday?'mustFillIn':''}}">
<text>出生日期</text>
<picker name="birthday" class="picker" bindchange="bindBirthday" value="{{birthday}}" mode="date">
<view class="picker__text">
{{birthday ? birthday: '请选择出生日期'}}
</view>
<image src="../../source/imageSource/page17_icon_triangle_n@3x.png" class="picker__right">
</image>
</picker>
</view>
<view class="input {{mustInputData.must_type?'mustFillIn':''}}">
<text>检查类型</text>
<picker name="type" class="picker" bindchange="bindType" range="{{typeList}}" range-key="name">
<view class="picker__text">
{{type ? type.name: '请选择检查类型'}}
</view>
<image src="../../source/imageSource/page17_icon_triangle_n@3x.png" class="picker__right">
</image>
</picker>
</view>
<view class="input {{mustInputData.must_idcard?'mustFillIn':''}}">
<text>身份证号</text>
<input name="certificateNum" bindinput='inputText' data-ids='certificateNum' maxlength="18" placeholder="请填写您的身份证号码" placeholder-class="input-placeholder" value='{{defaultInfo.certificateNum ? defaultInfo.certificateNum : ""}}'/>
</view>
<view class="input registeredPermanentResidenceCategory">
<text>户籍类型</text>
<picker name="accountType" class="picker" bindchange="bindAccountType" value="{{accountTypeIndex}}" range="{{accountType}}" range-key="name">
<view class="picker__text">
{{accountTypeEntity ? accountTypeEntity.name : '请选择您的户籍类型'}}
</view>
<image src="../../source/imageSource/page17_icon_triangle_n@3x.png" class="picker__right">
</image>
</picker>
</view>
<view class="input">
<text>居住类别</text>
<picker name="resideType" class="picker" bindchange="bindResideType" value="{{resideTypeIndex}}" range="{{resideType}}" range-key="name">
<view class="picker__text">
{{resideTypeEntity ? resideTypeEntity.name : '请选择您的居住类别'}}
</view>
<image src="../../source/imageSource/page17_icon_triangle_n@3x.png" class="picker__right">
</image>
</picker>
</view>
<view class="input {{mustInputData.must_educationLevel?'mustFillIn':''}}">
<text>文化程度</text>
<picker name="educationLevel" class="picker" bindchange="bindEducationLevel" value="{{educationLevelIndex}}" range="{{educationLevel}}" range-key="name">
<view class="picker__text">
{{educationLevelEntity ? educationLevelEntity.name : '请选择您的文化程度'}}
</view>
<image src="../../source/imageSource/page17_icon_triangle_n@3x.png" class="picker__right">
</image>
</picker>
</view>
<view class="input {{mustInputData.must_job?'mustFillIn':''}}">
<text>职业类别</text>
<picker name="job" class="picker" bindchange="bindJob" value="{{jobIndex}}" range="{{job}}" range-key="name">
<view class="picker__text">
{{jobEntity ? jobEntity.name : '请选择您的职业类别'}}
</view>
<image src="../../source/imageSource/page17_icon_triangle_n@3x.png" class="picker__right">
</image>
</picker>
</view>
<view class="input {{mustInputData.must_phone?'mustFillIn':''}}">
<text>联系方式</text>
<input name="phone" bindinput='inputText' data-ids='phone' maxlength="11" placeholder="请填写您的手机号码" placeholder-class="input-placeholder" />
</view>
<view class="input {{mustInputData.must_workUnit?'mustFillIn':''}}">
<text>工作单位</text>
<input name="workUnit" bindinput='inputText' data-ids='workUnit' maxlength="11" placeholder="请填写您的工作单位" placeholder-class="input-placeholder"/>
</view>
<view class="input address {{mustInputData.must_currentAddress?'mustFillIn':''}}">
<text>居住地址</text>
<view class="add_picker">
<view wx:if="{{!currentAddress.details}}" class="add_picker__text" bindtap="showAreaSelector" id="currentAddress"
data-name="currentAddress">请选择省市区(县)</view>
<view name="provinceCityArea" wx:if="{{currentAddress.details}}" class="add_picker__text" bindtap="showAreaSelector"
data-name="currentAddress">{{currentAddress.details}}</view>
</view>
<image src="../../source/imageSource/page17_icon_triangle_n@3x.png" class="address__picker__right">
</image>
<input name="currentAddress_input" class="address__input"
placeholder="输入街道门牌，无需重复地区" placeholder-class="input-placeholder" bindfocus="getFocus" bindinput='inputAddress' data-ids='jz'
value='{{defaultInfo.currentAddress_input}}' />
</view>
<!--<view class="input address {{mustInputData.must_permanentAddress?'mustFillIn':''}}">
<text>户籍地址</text>
<view class="add_picker">
<view wx:if="{{!permanentAddress.details}}" class="add_picker__text" bindtap="showAreaSelector" data-name="permanentAddress">请选择省市区(县)</view>
<view name="provinceCityArea" wx:if="{{permanentAddress.details}}" class="add_picker__text" bindtap="showAreaSelector" data-name="permanentAddress">{{permanentAddress.details}}</view>
<view class="add_picker__btn" data-ids='hj' bindlongtap='tongshang'>长按引用居住信息</view>
</view>
<image src="../../source/imageSource/page17_icon_triangle_n@3x.png" class="address__picker__right">
</image>
<input name="permanentAddress_input" class="address__input" placeholder="输入街道门牌，无需重复地区" placeholder-class="input-placeholder" bindfocus="getFocus" bindinput='inputAddress' data-ids='hj' value='{{defaultInfo.permanentAddress_input}}' />
</view>
<view class="input">
<text>既往史</text>
<picker name="pastHistory" class="picker" bindchange="bindPastHistory" range="{{yesOrNoList}}" range-key="name">
<view class="picker__text">
{{pastHistory ? pastHistory.name : '请选择'}}
</view>
<image src="../../source/imageSource/page17_icon_triangle_n@3x.png" class="picker__right">
</image>
</picker>
</view>
<view class="checkbox-sty" wx:if="{{pastHistory.id==='2'}}">
<checkbox-group bindchange="checkboxChange">
<checkbox value="{{item.value}}" wx:for="{{items}}" wx:key="id">
{{item.name}}
</checkbox>
</checkbox-group>
</view>
<view class="input" wx:if="{{showJw}}">
<text>其他内容</text>
<input name="jwQtText" bindinput='inputText' data-ids='jwQtText' placeholder="请填写既往史其他内容" placeholder-class="input-placeholder" />
</view>
<view class="input">
<text>家族史</text>
<picker name="familyHistory" class="picker" bindchange="bindFamilyHistory" range="{{yesOrNoList}}" range-key="name">
<view class="picker__text">
{{familyHistory ? familyHistory.name : '请选择'}}
</view>
<image src="../../source/imageSource/page17_icon_triangle_n@3x.png" class="picker__right">
</image>
</picker>
</view>
<view class="checkbox-sty" wx:if="{{familyHistory.id==='2'}}">
<checkbox-group bindchange="checkboxChange1">
<checkbox value="{{item.value}}" wx:for="{{items1}}" wx:key="id">
{{item.name}}
</checkbox>
</checkbox-group>
</view>
<view class="input" wx:if="{{showJz}}">
<text>其他内容</text>
<input name="jzQtText" bindinput='inputText' data-ids='jzQtText' placeholder="请填写家族史其他内容" placeholder-class="input-placeholder" />
</view>
<view class="input">
<text>个人史</text>
<picker name="familyHistory" class="picker" bindchange="bindPersonalHistory" range="{{yesOrNoList}}" range-key="name">
<view class="picker__text">
{{personalHistory ? personalHistory.name : '请选择'}}
</view>
<image src="../../source/imageSource/page17_icon_triangle_n@3x.png" class="picker__right">
</image>
</picker>
</view>
<view class="checkbox-sty" wx:if="{{personalHistory.id==='2'}}">
<checkbox-group bindchange="checkboxChange2">
<checkbox value="{{item.value}}" wx:for="{{items2}}" wx:key="id">
{{item.name}}
</checkbox>
</checkbox-group>
</view>
<view class="input" wx:if="{{showGr}}">
<text>其他内容</text>
<input name="grQtText" bindinput='inputText' data-ids='grQtText' placeholder="请填写个人史其他内容" placeholder-class="input-placeholder" />
</view>
<view class="input">
<text>药物过敏史</text>
<picker name="ywgmHistory" class="picker" bindchange="bindYwgmHistory" range="{{yesOrNoList}}" range-key="name">
<view class="picker__text">
{{ywgmHistory ? ywgmHistory.name : '请选择'}}
</view>
<image src="../../source/imageSource/page17_icon_triangle_n@3x.png" class="picker__right">
</image>
</picker>
</view>
<view class="checkbox-sty" wx:if="{{ywgmHistory.id==='2'}}">
<checkbox-group bindchange="checkboxChange3">
<checkbox value="{{item.value}}" wx:for="{{items3}}" wx:key="id">
{{item.name}}
</checkbox>
</checkbox-group>
</view>
<view class="input" wx:if="{{showGm}}">
<text>其他内容</text>
<input name="gmQtText" bindinput='inputText' data-ids='gmQtText' placeholder="请填写药物过敏史其他内容" placeholder-class="input-placeholder" />
</view>
<view class="input">
<text>现病史</text>
<picker name="presentHistory" class="picker" bindchange="bindPresentHistory" range="{{yesOrNoList}}" range-key="name">
<view class="picker__text">
{{presentHistory ? presentHistory.name : '请选择'}}
</view>
<image src="../../source/imageSource/page17_icon_triangle_n@3x.png" class="picker__right">
</image>
</picker>
</view>
<view class="input" wx:if="{{presentHistory.id==='2'}}">
<text>其他内容</text>
<input name="xbQtText" bindinput='inputText' data-ids='xbQtText' placeholder="请填写现病史其他内容" placeholder-class="input-placeholder" />
</view>-->
<button class="next" formType="submit" style="width: 670rpx;">保存</button>
<view class="blankbottom"></view>
</view>
</form>
<!--引入选择器布局-->
<include src="../../utils/areaSelector/selector.wxml" />