clarms-plugins-verifyform.vue 2.78 KB
<template>
  <div class="reservation-container">
    <div class="title"><u><span class="pointer" @click="toRegisterPage">{{$t('clarms.step1.register')}}</span>/<span class="pointer" @click="toLoginPage">{{$t('clarms.step1.login')}}</span></u>{{$t('clarms.step1.t1')}}</div>
    <div class="form-name default-mt"> {{$t('clarms.step1.label0')}}</div>
    <div class="gird-g form default-mt">
      <div class="pure-u-1 pure-u-md-1-2 form-item">
        <div class="label">
          {{$t('clarms.step1.label1')}}
        </div>
        <div class="ipt-wrap">
          <input class="ipt" type="text" v-model="data.lastName">
        </div>
      </div>

      <div class="pure-u-1 pure-u-md-1-2 form-item">
        <div class="label">
          {{$t('clarms.step1.label2')}}
        </div>
        <div class="ipt-wrap">
          <input class="ipt" type="text" v-model="data.firstName">
        </div>
      </div>

      <div class="pure-u-1 pure-u-md-1-2 form-item">
        <div class="label">
          {{$t('clarms.step1.label3')}}
        </div>
        <div class="ipt-wrap">
          <div class="down-arrow"></div>
          <el-select class="ipt" v-model="data.idType" :placeholder="$t('clarms.step2.placeHolder1')">
            <el-option v-for="(item, index) in policyIdTypeList" :key="index" :label="item.n" :value="item.v"></el-option>
          </el-select>
        </div>
      </div>

      <div class="pure-u-1 pure-u-md-1-2 form-item">
        <div class="label">
          {{$t('clarms.step1.label4')}}
        </div>
        <div class="ipt-wrap">
          <input class="ipt" type="text" v-model="data.idNo">
        </div>
      </div>

      <div class="pure-u-1 pure-u-md-1-2 form-item">
        <div class="label">
          {{$t('clarms.step1.label5')}}
        </div>
        <div class="ipt-wrap">
          <div class="down-arrow"></div>
          <date-picker class="ipt-date" v-model="data.birthDate" :filtModel="['future']" :check="checkDate" :cusStyle="{border:'none !important','background-color':'transparent !important',height:'3rem', padding:'0', color:'#606266'}"></date-picker>
        </div>
      </div>
    </div>
    <div class="submit-btn pointer flex-center" @click="handleConfirm" :class="{disabled : btnDisabled}">
      <van-loading v-if="loading" />
      <span>{{$t('clarms.step1.btn')}}</span>
    </div>
    <div class="tips" v-if="showTips">
      <img class="icon" src="@/assets/images/common/icon-alert-i.png" alt="">
      <div class="txt">
        {{$t('customService.insuranceQuery.noPolicy')}}
        <span class="pointer btn" @click="toContactUs">{{$t('customService.insuranceQuery.customService')}}</span>
      </div>
    </div>
  </div>
</template>

<script src="./clarms-plugins-verifyform.js"></script>
<style lang="scss" scoped>
@import "./clarms-plugins-verifyform.scss";
</style>