screen/application/admin/view/coupon/edit.html

<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Type')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-type" data-rule="required" min="0" class="form-control" name="row[type]" type="number" value="{$row.type|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Amount')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-amount" data-rule="required" min="0" class="form-control" step="0.01" name="row[amount]" type="number" value="{$row.amount|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Mount_full')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-mount_full" min="0" class="form-control" step="0.01" name="row[mount_full]" type="number" value="{$row.mount_full|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Num')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-num" min="0" class="form-control" name="row[num]" type="number" value="{$row.num|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Num_send')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-num_send" min="0" class="form-control" name="row[num_send]" type="number" value="{$row.num_send|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Time_start')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-time_start" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[time_start]" type="text" value="{$row.time_start}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Time_end')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-time_end" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[time_end]" type="text" value="{$row.time_end}">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>