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<table width="740" border="1" align="left">
<tr bgcolor="#006699">
<td width="37"><div align="center"><font color="#FFFFFF">险 种</font></div></td>
<td width="92"><div align="center"><font color="#FFFFFF">车损险</font></div></td>
<td width="80"><div align="center"><font color="#FFFFFF">第三责任险</font></div></td>
<td width="84"><div align="center"><font color="#FFFFFF">司乘人员险</font></div></td>
<td width="90" bgcolor="#006699"> <div align="center"><font color="#FFFFFF">货物承责险</font></div></td>
<td width="111"><div align="center"><font color="#FFFFFF">货物公定险</font></div></td>
<td width="94"><div align="center"><font color="#FFFFFF">不计免赔</font></div></td>
<td width="100"><div align="center">
<input name="oo2" type="text" class="input_plane2" id="oo" onmouseover="this.style.backgroundColor='#e1f4ee'" onmouseout="this.style.backgroundColor='#ffffff'" size="15">
</div></td>
</tr>
<tr>
<td width="37" height="20"> <div align="center">保 额</div></td>
<td width="92"> <div align="center">
<input name="yy" type="text" class="input_plane2" id="yy" size="5">
元</div></td>
<td width="80"> <div align="center">
<input name="zz" type="text" class="input_plane2" id="zz" size="5">
万元</div></td>
<td width="84"> <div align="center">
<input name="aa1" type="text" class="input_plane2" id="aa1" size="5">
万元</div></td>
<td width="90"> <div align="center">
<input name="aa2" type="text" class="input_plane2" id="aa2" size="5">
万元</div></td>
<td width="111"> <div align="center">
<input name="aa3" type="text" class="input_plane2" id="aa3" size="5">
万元</div></td>
<td width="94"> <div align="center">
<input name="aa4" type="text" class="input_plane2" id="aa4" size="5">
万元</div></td>
<td width="100"><div align="center">
<input name="aa42" type="text" class="input_plane2" id="aa42" size="5">
万元</div></td>
</tr>
<tr>
<td width="37" height="20"> <div align="center">保 费</div></td>
<td width="92"> <div align="center">
<input name="aa5" type="text" class="input_plane2" id="aa5" size="5">
元</div></td>
<td width="80"> <div align="center">
<input name="aa6" type="text" class="input_plane2" id="aa6" size="5">
元</div></td>
<td width="84"> <div align="center">
<input name="aa7" type="text" class="input_plane2" id="aa7" size="5">
元</div></td>
<td width="90"> <div align="center">
<input name="aa8" type="text" class="input_plane2" id="aa8" size="5">
元</div></td>
<td width="111"> <div align="center">
<input name="aa9" type="text" class="input_plane2" id="aa9" size="5">
元</div></td>
<td width="94"> <div align="center">
<input name="aa10" type="text" class="input_plane2" id="aa10" size="5">
元</div></td>
<td width="100"><div align="center">
<input name="aa43" type="text" class="input_plane2" id="aa43" size="5">
元</div></td>
</tr>
</table>
<p> </p>
<p> </p>
<table width="740" border="1">
<tr>
<td width="12">备 注</td>
<td width="293"><textarea name="bb1" cols="40" rows="5" wrap="PHYSICAL" id="textarea4" onmouseover="this.style.backgroundColor='#e1f4ee'" onmouseout="this.style.backgroundColor='#ffffff'"></textarea></td>
<td width="373"><table width="346" align="left">
<tr>
<td width="73" height="122">安全记录</td>
<td width="261"><textarea name="bb2" cols="45" rows="5" wrap="PHYSICAL" id="bb2" onmouseover="this.style.backgroundColor='#e1f4ee'" onmouseout="this.style.backgroundColor='#ffffff'"></textarea></td>
</tr>
</table></td>
</tr>
</table>
<table width="740">
<tr>
<td bgcolor="#006699"><font color="#FFFF00">第三步：行车事故理赔处理添加</font></td>
</tr>
</table>
<table width="740" border="1">
<tr>
<td width="60" height="25">日 期</td>
<td width="385"><select name="bb3" id="select14">
<option value="1998">1998</option>
<option value="1999">1999</option>
<option value="2000">2000</option>
<option value="2001">2001</option>
<option value="2002">2002</option>
<option value="2003">2003</option>
<option value="2004">2004</option>
<option value="2005">2005</option>
<option value="2006">2006</option>
<option value="2007">2007</option>
<option value="2008">2008</option>
<option value="2009">2009</option>
<option value="2010">2010</option>
<option value="2011">2011</option>
<option value="2012">2012</option>
</select>
年
<select name="bb4" id="select13">
<option value="01">01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
</select>
月
<select name="bb5" id="select7">
<option value="01">01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select>
日
<input name="bb6" type="text" class="input_plane2" id="bb6" size="8">
时</td>
<td width="44"><div align="center">编 号</div></td>
<td width="70"><input name="bb7" type="text" class="input_plane2" id="bb7" size="8"></td>
<td width="50"><div align="center">驾驶员</div></td>
<td width="91"><input name="bb8" type="text" class="input_plane2" id="bb8" size="10"></td>
</tr>
</table>
<table width="740" border="1">
<tr>
<td width="39" height="20">责 任</td>
<td width="70"><input name="bb9" type="text" class="input_plane2" id="bb9" size="10"></td>
<td width="65">处理部门</td>
<td width="140"><input name="bb10" type="text" class="input_plane2" id="bb10" size="20"></td>
<td width="58">经办人</td>
<td> <input name="cc1" type="text" class="input_plane2" id="cc12" size="15"></td>
</tr>
</table>
<table width="740" border="1">
<tr>
<td width="79" height="59">事故简况</td>
<td width="645"><textarea name="cc3" cols="55" rows="5" wrap="PHYSICAL" id="cc3" onmouseover="this.style.backgroundColor='#e1f4ee'" onmouseout="this.style.backgroundColor='#ffffff'"></textarea></td>
</tr>
</table>
<table width="740" border="1">
<tr>
<td width="78" rowspan="2">车物损失情况</td>
<td width="419" rowspan="2"><textarea name="cc4" cols="55" rows="5" wrap="PHYSICAL" id="textarea2" onmouseover="this.style.backgroundColor='#e1f4ee'" onmouseout="this.style.backgroundColor='#ffffff'"></textarea></td>
<td width="74" rowspan="2"><div align="center">保险估价</div></td>
<td width="45" height="44">工时费</td>
<td width="90"><input name="cc5" type="text" class="input_plane2" id="cc5" size="10"></td>
</tr>
<tr>
<td>材料费</td>
<td><input name="cc6" type="text" class="input_plane2" id="cc6" size="10"></td>
</tr>
</table>
<table width="740" border="1">
<tr>
<td width="51" rowspan="2">理赔记录</td>
<td width="52"><div align="center">送赔时间</div></td>
<td width="80"><input name="cc7" type="text" class="input_plane2" id="cc7" size="10"></td>
<td width="58"><div align="center">送赔金额</div></td>
<td width="105"><input name="cc8" type="text" class="input_plane2" id="cc8" size="10">
元</td>
<td width="103"><div align="center">事故损失差额</div></td>
<td width="105"><input name="cc9" type="text" class="input_plane2" id="pp" size="15"></td>
</tr>
<tr>
<td><div align="center">赔回时间</div></td>
<td><input name="cc10" type="text" class="input_plane2" id="cc10" size="10"></td>
<td width="58"><div align="center">赔回金额</div></td>
<td width="105"><input name="dd1" type="text" class="input_plane2" id="dd1" size="10">
元</td>
<td width="103"><div align="center">索赔部门</div></td>
<td width="105"><input name="dd2" type="text" class="input_plane2" id="dd2" size="15"></td>
</tr>
</table>
<table width="740" border="1">
<tr>
<td width="66">对方赔付</td>
<td width="188"><input name="dd3" type="text" class="input_plane2" id="dd3" size="18">
元</td>
<td width="464"> </td>
</tr>
</table>
<table width="740" border="1">
<tr>
<td width="65" rowspan="2">处理意见</td>
<td width="105" rowspan="2"><select name="dd4" id="select8">
<option value="请选择" selected>请选择</option>
<option value="待岗">待岗</option>
<option value="解聘">解聘</option>
</select></td>
<td width="78">承担经济损失 </td>
<td width="152"><input name="dd5" type="text" class="input_plane2" id="dd5" size="18">
元</td>
<td width="87"><div align="center">合 计</div></td>
<td width="213"><input name="dd6" type="text" class="input_plane2" id="dd6" size="18"></td>
</tr>
<tr>
<td><div align="center">罚 款</div></td>
<td><input name="dd7" type="text" class="input_plane2" id="dd7" size="18">
元</td>
<td width="87"><div align="center">执行时间</div></td>
<td width="213"><input name="dd8" type="text" class="input_plane2" id="yy22" size="18"></td>
</tr>
</table>
<table width="740" border="1">
<tr>
<td width="65"><div align="center">备注</div></td>
<td width="519"><textarea name="dd9" cols="70" rows="4" wrap="PHYSICAL" id="textarea3" onmouseover="this.style.backgroundColor='#e1f4ee'" onmouseout="this.style.backgroundColor='#ffffff'"></textarea></td>
</tr>
</table>
<table width="600">
<tr>
<td> <div align="center">
<input name="Submit" type="submit" class="button" value="确 认 提 交" >
<input name="Submit2" type="reset" class="button" value="重 新 登 记" >
</div></td>
</tr>
</table>
</form></td>
</tr>
</table>
</body>
</html>
<script language=javascript>
function CheckForm()
{
if(document.form1.aa.value=="")
{
alert("请输入编号！");
document.form1.aa.focus();
return false;
}
if(document.form1.bb.value=="")
{
alert("请输入经营者名字！");
document.form1.bb.focus();
return false;
}
if(document.form1.cc.value == "")
{
alert("请输入车牌号！");
document.form1.cc.focus();
return false;
}
if(document.form1.ee.value == "")
{
alert("请选择车型！");
document.form1.ee.focus();
return false;
}
if(document.form1.ff.value == "")
{
alert("请输入吨位！");
document.form1.ff.focus();
return false;
}
}
</script>⌨️ 快捷键说明
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