@layout("/common/_container.html"){
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<div class="ibox float-e-margins">
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<div class="ibox-content">
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<div class="form-horizontal">
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<div class="row">
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<div class="col-sm-10">
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<#input id="userId" name="用户id" />
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<#input id="orderId" name="关联订单id" />
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<#input id="realName" name="申请人姓名" />
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<#input id="takeName" name="收件人姓名" />
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<#input id="takePhone" name="收件人电话" />
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<#input id="takeAddress" name="收件人地址" />
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</div>
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</div>
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<div class="row btn-group-m-t">
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<div class="col-sm-10 col-sm-offset-5">
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<#button btnCss="info" name="提交" id="ensure" icon="fa-check" clickFun="MyUserSubstanceCouponInfoDlg.addSubmit()"/>
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<#button btnCss="danger" name="取消" id="cancel" icon="fa-eraser" clickFun="MyUserSubstanceCouponInfoDlg.close()"/>
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</div>
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</div>
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</div>
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</div>
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</div>
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<script src="${ctxPath}/static/modular/system/myUserSubstanceCoupon/myUserSubstanceCoupon_info.js"></script>
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@}
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