Sindbad~EG File Manager

{% extends 'neuro_backoffice/bo_layout.html' %}
 {% block title %}Payment{% endblock %} 
 {% block content %}

 <div class="row">
 	<!-- <div class="col-lg-2 col-md-2 col-sm-12" > </div> -->
 	<div class="col-md-12" >
 		<div class="d-flex justify-content-md-center align-items-center vh-100">
 			<!-- <div class="card-header"><h4>Paid by</h4></div> -->

 			<div class="col-md-5 box">
 				<img src="../static/images/logo.png" alt="VRSI 2022" class="mx-auto d-block">
 				<h4 class="text-center font-weight-bold">Paid by</h4>
 				<form id="payment_form" action="{{url_for('user.PostPayment')}}" method="POST" >
 				<div class="row">
 					<div class="col-lg-1 col-md-1 col-sm-12"></div>
 					<div class="col-lg-10 col-md-10 col-sm-12">
 						<div class="row">
 							<div class="col-lg-4 col-md-12 col-sm-12">
 								<label>Full Name</label>
 							</div>
 							<div class="col-lg-8 col-md-12 col-sm-12">
 								<input type="text" class="form-control" name="full_name" id="full_name" value="{{userData.full_name or '' }}" placeholder="Enter full name" required>
 							</div>
 						</div><br/>

 						<div class="row">
 							<div class="col-lg-4 col-md-12 col-sm-12">
 								<label>Email</label>
 							</div>
 							<div class="col-lg-8 col-md-12 col-sm-12">
 								<input type="text" class="form-control" name="email" id="email" value="{{userData.email or '' }}" placeholder="Enter email-id" readonly>
 							</div>
 						</div><br/>


 						<div class="row">
 							<div class="col-lg-4 col-md-12 col-sm-12">
 								<label>Mobile</label>
 							</div>
 							<div class="col-lg-8 col-md-12 col-sm-12">
 								<input type="text" class="form-control" name="mobile" id="mobile" value="{{userData.mobile or '' }}" placeholder="Enter mobile number" required>
 							</div>
 						</div><br/>

 						<div class="row">
 							<div class="col-lg-4 col-md-12 col-sm-12">
 								<label>Amount</label>
 							</div>
 							<div class="col-lg-8 col-md-12 col-sm-12">
 								<input type="text" class="form-control" name="amount" id="amount" value="900.00" placeholder="Enter amount" required readonly>
 							</div>
 						</div><br/>

 						<div class="row">
 							<div class="col-lg-12 col-md-12 col-sm-12 text-center">
 								<input type="hidden" name="user_id" id="user_id" value="{{user_id}}" >
 								<input type="hidden" name="encrypt_user_id" id="encrypt_user_id" value="{{encrypt_user_id}}">
 								<input type="submit" class="btn btn-success" name="pay_btn" id="pay_btn" value="Pay Now">
 							</div>
 							
 						</div>
 				        
 				        
 					</div>
 					<div class="col-lg-1 col-md-1 col-sm-12"></div>

 				</div>
 				</form>
 				


 			</div>
 		</div>
 		
 	</div>
 	<div class="col-lg-2 col-md-2 col-sm-12" > </div>
 </div>

 {% endblock %}