<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('User_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-user_id" data-rule="required" data-source="user/user/index" data-field="nickname" class="form-control selectpage" name="row[user_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Type')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-type" class="form-control" name="row[type]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Stores_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-stores_id" data-rule="required" data-source="stores/index" class="form-control selectpage" name="row[stores_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Vip_type')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-vip_type" class="form-control" name="row[vip_type]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Province_ids')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-province_ids" data-rule="required" data-source="province/index" data-multiple="true" class="form-control selectpage" name="row[province_ids]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Num')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-num" class="form-control" name="row[num]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Money')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-money" class="form-control" name="row[money]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Status')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-status" class="form-control" name="row[status]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Audit')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-audit" class="form-control" name="row[audit]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Paytime')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-paytime" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[paytime]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Expirationtime')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-expirationtime" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[expirationtime]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>