@include('includes.partials.messages')
{!! Form::open(array('method' => 'POST', 'id' => 'frm_payment')) !!}
{!! Form::hidden('order_id', $data['order']->id) !!}
{!! Form::close() !!}
Credit Card Details
{!! Form::checkbox('same_billing_info', true, $data['v_billing_details']['same_billing_info'], ['id' => 'same_billing_info']) !!}
{!! Form::label('email', 'Email Address: *') !!}
{!! Form::text('email', $data['v_billing_details']['email'], ['required' => 'required', 'type' => 'email', 'class' => 'text_input', 'placeholder' => 'Enter email address ...', 'id' => 'bl_email']) !!}
{!! Form::label('first_name', 'First Name: *') !!}
{!! Form::text('first_name', $data['v_billing_details']['first_name'],['required' => 'required', 'class'=>'text_input', 'placeholder'=>'Enter first name ...', 'id' => 'bl_first_name']) !!}
{!! Form::label('last_name', 'Last Name: *') !!}
{!! Form::text('last_name', $data['v_billing_details']['last_name'],['required' => 'required', 'class'=>'text_input', 'placeholder'=>'Enter last name ...', 'id' => 'bl_last_name']) !!}
{!! Form::label('company', 'Company:') !!}
{!! Form::text('company', $data['v_billing_details']['company'],['class'=>'text_input', 'placeholder'=>'Enter company name ...', 'id' => 'bl_company']) !!}
{!! Form::text('address1', $data['v_billing_details']['address1'],['required' => 'required', 'class'=>'text_input', 'placeholder'=>'Enter address line 1...', 'id' => 'bl_address1']) !!}
{!! Form::text('address2', $data['v_billing_details']['address2'],['class'=>'text_input', 'placeholder'=>'Enter address line 2 ...', 'id' => 'bl_address2']) !!}
{!! Form::label('country', 'Country: *') !!}
{!! Form::select('country', $data['countries'], $data['v_billing_details']['country'],['required' => 'required', 'class'=>'text_input', 'onchange="get_states(this.value);"', 'placeholder'=>'Select country ...', 'id' => 'bl_country']) !!}
{!! Form::label('state', 'State: *') !!}
@php
$show_text_field = true;
if(isset($data['address']))
{
if(is_numeric($data['address']->state))
$show_text_field = false;
}
@endphp
@if($show_text_field)
{!! Form::text('state', $data['v_billing_details']['state'], ['required' => 'required', 'class'=>'text_input', 'placeholder'=>'Enter state ...']) !!}
@else
{!! Form::select('state', $data['states'], $data['v_billing_details']['state'],['required' => 'required', 'class'=>'text_input', 'placeholder'=>'Enter state ...']) !!}
@endif
{!! Form::label('city', 'City: *') !!}
{!! Form::text('city', $data['v_billing_details']['city'],['required' => 'required', 'class'=>'text_input', 'placeholder'=>'Enter city ...', 'id' => 'bl_city']) !!}
{!! Form::label('zip', 'Zip / Post Code: *') !!}
{!! Form::text('zip', $data['v_billing_details']['zip'],['required' => 'required', 'maxlength' => '9', 'class'=>'text_input', 'placeholder'=>'Enter zip / post code ...', 'id' => 'bl_zip']) !!}
{!! Form::label('phone', 'Phone: *') !!}
{!! Form::text('phone', $data['v_billing_details']['phone'],['required' => 'required', 'class'=>'text_input', 'placeholder'=>'Enter phone ...', 'id' => 'bl_phone']) !!}
{!! Form::label('cc_number', 'Card Number:') !!}
{!! Form::text('cc_number', null, ['maxlength' => 23, 'oninput' => 'this.value = this.value.replace(/[^0-9-]/g, "");', 'required' => 'required', 'class' => 'form-control left_payment_cart_icon', 'placeholder' => 'Card Number ...', 'id' => 'cc_number']) !!}
{!! Form::hidden('cc_type', null, ['id' => 'cc_type']) !!}
{!! Form::label('cc_month', 'Expiry Month:') !!}
{!! Form::select('cc_month', $data['months'], null, ['required' => 'required', 'class'=>'text_input', 'placeholder'=>'Please Select ...']) !!}
{!! Form::label('cc_year', 'Expiry Year:') !!}
{!! Form::select('cc_year', $data['years'], null, ['required' => 'required', 'class'=>'text_input', 'placeholder'=>'Please Select ...']) !!}
{!! Form::label('cc_cvv', 'CVC:') !!}
{!! Form::text('cc_cvv', null, [
'required' => 'required',
'class' => 'text_input',
'placeholder' => 'Enter CVC ...',
'maxlength' => 4,
'pattern' => '[0-9]*',
'inputmode' => 'numeric',
'oninput' => 'this.value = this.value.replace(/[^0-9]/g, "");' // Regex to replace any non-numeric character
]) !!}
{!! Form::checkbox('terms', true, 0, ['id' => 'terms']) !!}
}})
SHIPPING ADDRESS
{{ \App\Models\Customer::getCustomerName($data['order']->customer_id) }} |
{{ $data['order']->email ?? 'N/A' }} |
{{ $data['order']->first_name . ' ' . $data['order']->last_name }} |
{{ $data['order']->company ?? 'N/A' }} |
{{ $data['order']->address1 }}, @if($data['order']->address2) {{ $data['order']->address2 ?? 'N/A' }}, @endif {{ $data['order']->city }}, {{ $data['order']->zip_code }}, @if(is_numeric($data['order']->state)) {{ \App\Models\State::get_state_name($data['order']->state) }}, @else {{ $data['order']->state }}, @endif {{ \App\Models\Country::get_country_name($data['order']->country) }} |
{{ $data['order']->phone ?? 'N/A' }} |
{{ $data['order']->notes ?? 'N/A' }} |
Change Address or Payment Method |