File size: 1.43Kb
<div class="page-container">
<div class="page-header">{$lng->report_track} - {$url_title}</div>
{$message}
<form action="{$url}/index.php?a=track&id={$id}&type=report" method="post">
<div class="page-inner">
<div class="page-input-container">
<div class="page-input-title">{$lng->ttl_description}</div>
<div class="page-input-content">
<textarea class="ads" name="description"></textarea>
<div class="page-input-sub">{$lng->report_description}</div>
</div>
</div>
<div class="page-input-container">
<div class="page-input-content">
<div class="report-checkbox"><input type="checkbox" name="report1" id="report1" value="1"><label for="report1">{$lng->report1}</label></div>
<div class="report-checkbox"><input type="checkbox" name="report2" id="report2" value="1"><label for="report2">{$lng->report2}</label></div>
<div class="report-checkbox"><input type="checkbox" name="report3" id="report3" value="1"><label for="report3">{$lng->report3}</label></div>
</div>
</div>
<div class="page-input-container">
<div class="page-input-title">{$lng->signature}</div>
<div class="page-input-content">
<input type="text" name="signature" />
<div class="page-input-sub">{$lng->sub_signature}</div>
</div>
</div>
</div>
<div class="divider"></div>
<div class="page-inner">
<div class="page-input-title"></div><input type="submit" name="copyright" value="{$lng->send}" />
</div>
</form>
</div>