{template "mheader.html"}

<div class="portlet light ">
    <div class="portlet-title">
        <div class="caption fc-mall-order-title">
           申请售后
        </div>
    </div>
    <div class="portlet-body form fc-form">

        <form action="" class="form-horizontal" method="post" name="myform" id="myform">
            {dr_form_hidden()}
            <div class="form-group">
                <label class="col-md-2 control-label">商品名称</label>
                <div class="col-md-9">
                    <p class="form-control-static"> {$item.title} </p>
                </div>
            </div>
            <div class="form-group">
                <label class="col-md-2 control-label">申请类型</label>
                <div class="col-md-9">
                    <p class="form-control-static"> {$type_name} </p>
                </div>
            </div>

            <div class="form-group">
                <label class="col-md-2 control-label"> 申请理由 </label>
                <div class="col-md-9">
                    <textarea class="form-control" style="height:150px; width:90%;" name="data[remark]"></textarea>
                </div>
            </div>

            <div class="form-group">
                <label class="col-md-2 control-label"> 上传凭证 </label>
                <div class="col-md-9">
                    {$images_field}
                </div>
            </div>

            <div class="form-actions fc-form-actions">
                <label class="col-md-2 control-label">  </label>
                <div class="col-md-9 fc-form-submit">
                    <button type="button" onclick="dr_ajax_submit('{dr_now_url()}', 'myform', '2000')" class="btn green"> 提交申请 </button>
                </div>

            </div>
        </form>

    </div>
</div>


{template "mfooter.html"}