<view class="{{['patient-form', virtualHostClass]}}" style="{{virtualHostStyle}}" hidden="{{virtualHostHidden || false}}" id="{{p}}"><view class="form-card"><view class="section-title">基本信息</view><view class="form-item"><text class="label required">姓名</text><input type="text" placeholder="请输入就诊人姓名" maxlength="20" value="{{a}}" bindinput="{{b}}"/></view><view class="form-item"><text class="label">证件类型</text><view class="value-text">{{c}}</view></view><view class="form-item"><text class="label">证件号码</text><view class="value-text">{{d}}</view></view><view class="form-item"><text class="label required">与本人关系</text><picker mode="selector" range="{{f}}" range-key="label" bindchange="{{g}}"><view class="picker"><text>{{e}}</text><text class="iconfont icon-arrow-right"></text></view></picker></view></view><view class="form-card"><view class="section-title">就诊卡信息</view><view class="form-item"><text class="label">就诊卡号</text><view class="value-text">{{h}}</view></view><view class="form-item"><text class="label required">手机号码</text><input type="number" placeholder="请输入手机号码" maxlength="11" value="{{i}}" bindinput="{{j}}"/></view></view><view class="form-card"><view class="switch-item"><text>设为默认就诊人</text><switch checked="{{k}}" bindchange="{{l}}" color="#0f95b0" disabled="{{m}}"/></view></view><view class="bottom-bar"><button class="submit-btn primary-btn" disabled="{{n}}" bindtap="{{o}}">保存</button></view></view>
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