{$layout "layout_popup"}

<h3>添加需要删除的Header</h3>
<form class="ui form" data-tea-action="$" data-tea-success="success">
	<input type="hidden" name="headerPolicyId" :value="headerPolicyId"/>
	<table class="ui table definition selectable">
		<tr>
			<td class="title">名称<em>（Name）</em></td>
			<td>
				<input type="text" name="name" maxlength="100" ref="focus"/>
			</td>
		</tr>
	</table>
	<submit-btn></submit-btn>
</form>