<view class="{{['refund-container', virtualHostClass]}}" style="{{virtualHostStyle}}" hidden="{{virtualHostHidden || false}}" id="{{s}}"><view class="order-card"><view class="hospital-info"><image src="{{a}}" mode="aspectFit" class="logo"/><view class="info"><text class="name">{{b}}</text><text class="department">{{c}}</text></view></view><view class="amount-info"><text class="label">支付金额</text><text class="amount">¥{{d}}</text></view></view><view class="refund-form card"><view class="section-title">退款信息</view><view class="form-item"><text class="label required">退款金额</text><view class="amount-input"><text class="currency">¥</text><input type="digit" maxlength="{{10}}" placeholder="请输入退款金额" value="{{e}}" bindinput="{{f}}"/></view><text class="max-amount">最多可退 ¥{{g}}</text></view><view class="form-item"><text class="label required">退款原因</text><picker mode="selector" range="{{i}}" range-key="label" bindchange="{{j}}"><view class="picker"><text>{{h}}</text><text class="iconfont icon-arrow-right"></text></view></picker></view><view class="form-item"><text class="label">退款说明</text><block wx:if="{{r0}}"><textarea placeholder="请输入退款说明(选填)" maxlength="{{200}}" class="desc-textarea" value="{{k}}" bindinput="{{l}}"/></block><text class="word-count">{{m}}/200</text></view><view class="form-item"><text class="label">上传凭证</text><view class="upload-list"><view wx:for="{{n}}" wx:for-item="image" wx:key="d" class="image-item"><image src="{{image.a}}" mode="aspectFill" bindtap="{{image.b}}"/><text class="delete" catchtap="{{image.c}}">×</text></view><view wx:if="{{o}}" class="upload-btn" bindtap="{{p}}"><text class="iconfont icon-add"></text><text>上传图片</text></view></view><text class="upload-tip">最多上传3张图片，每张不超过5MB</text></view></view><view class="notice-card"><view class="section-title">退款说明</view><view class="notice-list"><view class="notice-item"><text class="dot"></text><text class="content">退款申请提交后，工作人员将在1-3个工作日内进行审核</text></view><view class="notice-item"><text class="dot"></text><text class="content">退款金额将原路退回到支付账户</text></view><view class="notice-item"><text class="dot"></text><text class="content">如有疑问，请联系客服：+853 2837 1333</text></view></view></view><view class="bottom-bar"><button class="submit-btn primary-btn" disabled="{{q}}" bindtap="{{r}}">提交申请</button></view></view>
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