{include file="header.tpl" title='提交工单' hostname=$c['网站名称']}

        <div class="wrapper">
            <div class="container-fluid">
		    <!-- start page title -->
		    <div class="row">
		        <div class="col-12">
    		            <div class="page-title-box">
		                <!-- <div class="page-title-right">
		                    <ol class="breadcrumb m-0">
		                        <li class="breadcrumb-item"><a href="javascript: void(0);">UBold</a></li>
		                        <li class="breadcrumb-item"><a href="javascript: void(0);">Pages</a></li>
		                        <li class="breadcrumb-item active">Starter</li>
		                    </ol>
		                </div> -->
		                <h4 class="page-title">工单提交</h4>
		            </div>
		        </div>
		    </div> 
		    <!-- end page title --> 

		    <div class="row">
		    	<div class="col-12">
		    		<div class="card">
	                    <div class="card-body">
 <center>                          
   

		<div class="panel-body">
			<form class="form-horizontal devform" method="post">
				<div class="form-group">
					<label class="col-sm-2 control-label">{$lang['姓名']}</label>
					<div class="col-sm-6">
						<input type="text" name="name" class="form-control">
					</div>
				
				</div>
				<div class="line line-dashed b-b line-lg pull-in"></div>
				<div class="form-group">
					<label class="col-sm-2 control-label">{$lang['电子邮件']}</label>
					<div class="col-sm-6">
						<input type="text" name="email" class="form-control"  value="" />
					</div>
				
				</div>
				<div class="line line-dashed b-b line-lg pull-in"></div>
				<div class="form-group">
					<label class="col-sm-2 control-label">主题名</label>
					<div class="col-sm-6">
						<input type="text" name="subject" class="form-control"  value="" />
					</div>
				
				</div>
				<div class="line line-dashed b-b line-lg pull-in"></div>
				<div class="form-group">
					<label  >内容</label>
					<div class="col-sm-6">
						<textarea name="message" class="form-control"  rows="12" value="" /></textarea>
					</div>
              <p>
				
<p>
				<div class="line line-dashed b-b line-lg pull-in"></div>
				<div class="line line-dashed b-b line-lg pull-in"></div>
				<div class="form-group">
					<div class="col-sm-4 col-sm-offset-2">
						<button class="btn btn-primary send-dev">提交工单</button>
					</div>
				</div>
			</form>
		</div></div></div>
           <p></div>  <p></div>          

 {include file="footer.tpl"}