<form action="/swt/" method="" name="gh_form" onSubmit="javascript:return check();">
<p>
<label>就诊姓名:</label>
<input type="text" name="name" placeholder="请输入您的姓名" class="input" />
</p>
<p>
<label>就诊日期:</label>
<input type="date" name="date" placeholder="年/月/日" class="input"/>
</p>
<p>
<label>联系方式:</label>
<input type="text" name="phone" placeholder="请输入您的手机号码" class="input" id="phone_1" maxlength="11"/>
<a href="tel:0756-8592828" id="phone">免费电话</a>
</p>
<p>
<label id="ms">病情描述:</label>
<textarea name="description" id="des" class="ms" placeholder="例如:脸上痘痘很多…"></textarea>
</p>
<p>
<input type="submit" value="提交挂号信息" id="submit" />
</p>
</form>
<script>
function check() {
var re=/[\u4E00-\u9FA5]/g;
if(document.gh_form.name.value==''){
alert('请填写姓名!');return false;
}else if(!re.test(gh_form.name.value)){
alert('请填写中文姓名!');return false;
}
var istel=/^(?:13\d|18\d|15\d)\d{5}(\d{3}|\*{3})$/;
if(!istel.test(gh_form.phone.value)){
alert("请正确填写电话号码");return false;
}
}
</script>