ss_new_ui_skin_and_page/page/biz/dwzgz_inp.ss.jsp

<div class='content-div' ssFith="true">
	<table class='form'>
		<tr>
			<th>名称</th>
			<td colspan="3"><input name="mc" width="168px"/></td>
		</tr>
		<tr>
			<th>颁发机构</th>
			<td><input name="bfjg" width="168px"/></td>
			<th>证件号</th>
			<td><input name="dwzgzh" width="168px"/></td>
		</tr>
		<tr>
			<th style="width:118px">有效期</th>
			<td colspan="3">
				<input name="yxksrq" width="80px"/>
				-
				<input name="yxjsrq" width="80px"/>
			</td>
		</tr>
		<tr>
			<td colspan="4" rowspan="8" width="180px">
				<input name="zwwj" placeholder="default-card.png"/>
			</td>
		</tr>
	</table>
</div>