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

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Verification_coupon_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-verification_coupon_id" data-rule="required" data-source="verification/coupon/index" class="form-control selectpage" name="row[verification_coupon_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Verification_store_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-verification_store_id" data-rule="required" data-source="verification/store/index" class="form-control selectpage" name="row[verification_store_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('User_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-user_id" data-rule="required" data-source="user/user/index" data-field="nickname" class="form-control selectpage" name="row[user_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Type')}:</label>
        <div class="col-xs-12 col-sm-8">
                        
            <select  id="c-type" class="form-control selectpicker" name="row[type]">
                {foreach name="typeList" item="vo"}
                    <option value="{$key}" {in name="key" value="0"}selected{/in}>{$vo}</option>
                {/foreach}
            </select>

        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Closetime')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-closetime" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[closetime]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Receive_no')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-receive_no" class="form-control" name="row[receive_no]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Qr_code')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-qr_code" class="form-control" name="row[qr_code]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Verification_order_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-verification_order_id" data-rule="required" data-source="verification/order/index" class="form-control selectpage" name="row[verification_order_id]" type="text" value="">
        </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>