<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">{:__('Uid')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-uid" data-rule="required" class="form-control" name="row[uid]" type="number">
        </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" data-rule="required" class="form-control" name="row[status]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Order_sn')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-order_sn" data-rule="required" class="form-control" name="row[order_sn]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Pay_order_sn')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-pay_order_sn" data-rule="required" class="form-control" name="row[pay_order_sn]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Receive_name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-receive_name" data-rule="required" class="form-control" name="row[receive_name]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Receive_mobile')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-receive_mobile" data-rule="required" class="form-control" name="row[receive_mobile]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Receive_address')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-receive_address" data-rule="required" class="form-control" name="row[receive_address]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Leave_message')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-leave_message" data-rule="required" class="form-control" name="row[leave_message]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Discount_price')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-discount_price" class="form-control" step="0.01" name="row[discount_price]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Total_goods_price')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-total_goods_price" class="form-control" step="0.01" name="row[total_goods_price]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Total_expense_price')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-total_expense_price" class="form-control" step="0.01" name="row[total_expense_price]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Total_price')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-total_price" class="form-control" step="0.01" name="row[total_price]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Coupon_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-coupon_id" data-rule="required" data-source="coupon/index" class="form-control selectpage" name="row[coupon_id]" type="text" value="">
        </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>