@extends('res::frameMUI')

@section('pageTitle','填写奖品领取地址')

@section('headAppend')
    <link rel="stylesheet" href="@assets('res/prizePool/default/mobile/css/style.css')">
@endsection

@section('body')

    <div class="mui-content">
        <form action="?" method="post" data-ajax-form onsubmit="return false;">
            <div class="pb-form">
                <div class="line">
                    <div class="label">奖品</div>
                    <div class="field">
                        <div class="value">
                            {{$drawn['name']}}
                        </div>
                    </div>
                </div>
                <div class="line">
                    <div class="label">姓名</div>
                    <div class="field">
                        <input type="text" name="userName" />
                    </div>
                </div>
                <div class="line">
                    <div class="label">手机</div>
                    <div class="field">
                        <input type="text" name="userPhone" />
                    </div>
                </div>
                <div class="line">
                    <div class="label">地址</div>
                    <div class="field">
                        <input type="text" name="userAddress" />
                    </div>
                </div>
                <div class="submit">
                    <button type="submit" class="mui-btn mui-btn-block mui-btn-primary">确定</button>
                </div>
            </div>
        </form>
    </div>

@endsection