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<?php $__env->startSection('title', 'Joruri Doctor | Payment Information'); ?> <?php $__env->startSection('content'); ?> <div class="main-content"> <div class="main-content-inner"> <div class="breadcrumbs ace-save-state" id="breadcrumbs"> <?php echo $__env->make('layouts.header_menu', \Illuminate\Support\Arr::except(get_defined_vars(), ['__data', '__path']))->render(); ?> </div> <div class="page-content"> <div class="row"> <div class="col-sm-3"></div> <div class="col-sm-6"> <div class="tabbable"> <ul class="nav nav-tabs" id="myTab"> <li class=""> <a data-toggle="tab" href="#dbbl" aria-expanded="false"> <i class="green ace-icon fa fa-credit-card bigger-120"></i> Dutch Bangla Bank </a> </li> <li class=""> <a data-toggle="tab" href="#rocket" aria-expanded="false"> <i class="green ace-icon fa fa-credit-card bigger-120"></i> Rocket </a> </li> <li class=""> <a data-toggle="tab" href="#nagad" aria-expanded="false"> <i class="green ace-icon fa fa-credit-card bigger-120"></i> Nagad </a> </li> <li class=""> <a data-toggle="tab" href="#bkash" aria-expanded="false"> <i class="green ace-icon fa fa-credit-card bigger-120"></i> Bkash </a> </li> </ul> <div class="tab-content"> <div id="dbbl" class="tab-pane fade"> <form action="<?php echo e(route('store_payment')); ?>" class="form-horizontal" role="form" method="POST" style="margin-top:10px;"> <?php echo csrf_field(); ?> <div class="" style="margin-top:10px;"> <div class="form-group"> <label class="col-sm-3 control-label no-padding-right" for="h_name"> Payer Name <span class="text-danger">*</span></label> <div class="col-sm-9"> <input type="text" id="name" placeholder="Full Name" class="form-control" name="payer_name" value="<?php echo e(Auth::user()->name); ?>" readonly> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label no-padding-right" for="monthly_charge"> Pay Amount <span class="text-danger">*</span></label> <div class="col-sm-9"> <input type="text" id="pay_amount" placeholder="Monthly Bill Amount" class="form-control" name="pay_amount" value="<?php echo e($package->package_amount); ?>" readonly> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label no-padding-right" for="pay_account"> Payment Account <span class="text-danger">*</span></label> <div class="col-sm-9"> <input type="text" readonly id="pay_account" placeholder="1621510091819" class="form-control" name="pay_account" value="1621510091819"> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label no-padding-right" for="tran_id"> Transaction Id <span class="text-danger">*</span></label> <div class="col-sm-9"> <input type="text" id="tran_id" placeholder="Enter Transaction Id After Payment" class="form-control" name="tran_id" required> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label no-padding-right" for="tran_id"> Payment Date <span class="text-danger">*</span></label> <div class="col-sm-9"> <input type="text" id="c_date" class="form-control" name="date" value="<?php echo e(date('Y-m-d')); ?>" /> </div> </div> <input class="hidden" type="text" name="pay_method" value="DBBL"> <input class="hidden" type="text" name="payer_id" value="<?php echo e(Auth::user()->customer_id); ?>"> <input class="hidden" type="text" name="payer_role" value="<?php echo e(Auth::user()->role); ?>"> <input class="hidden" type="text" name="package_id" value="<?php echo e($package->id); ?>"> <div class="form-group"> <div class="col-sm-9"> <div class="btn-group pull-right"> <button type="submit" class="btn btn-primary btn-round">Submit Payment </button> </div> </div> </div> </div> </form> </div> <div id="rocket" class="tab-pane fade"> <p class="text-danger" style="font-weight: bold;line-height: 2.5;">রকেট আক্যাউন্ট থেকে এই <span class="label label-lg label-danger arrowed-right">017149662143</span> নাম্বারে নিচের <span class="label label-info label-white middle"> Pay Amount </span> কৃত টাকা সেন্ডমানি করুন । সেন্ডমানি সফল হলে <span class="label label-info label-white middle">Transaction Id </span> ঘরে ট্রানজেকসন আইডি বসিয়ে <span class="label label-info label-white middle"> Submit Payment </span> ক্লিক করুন । যে কোন প্রয়োজনে যোগাযোগ করুন - <strong><a href="https://www.facebook.com/mdredwanullah1996" target="_blank" title="Facebook">Facebook</a></strong></p> <form action="<?php echo e(route('store_payment')); ?>" class="form-horizontal" role="form" method="POST" style="margin-top:10px;"> <?php echo csrf_field(); ?> <div class="" style="margin-top:10px;"> <div class="form-group"> <label class="col-sm-3 control-label no-padding-right" for="h_name"> Payer Name <span class="text-danger">*</span></label> <div class="col-sm-9"> <input type="text" id="name" placeholder="Full Name" class="form-control" name="payer_name" value="<?php echo e(Auth::user()->name); ?>" readonly> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label no-padding-right" for="monthly_charge"> Pay Amount <span class="text-danger">*</span></label> <div class="col-sm-9"> <input type="text" id="pay_amount" placeholder="Monthly Bill Amount" class="form-control" name="pay_amount" value="<?php echo e($package->package_amount - $package->package_discount); ?>" readonly> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label no-padding-right" for="pay_account"> Payment Account <span class="text-danger">*</span></label> <div class="col-sm-9"> <input type="text" readonly id="pay_account" placeholder="017149662143" class="form-control" name="pay_account" value="017149662143"> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label no-padding-right" for="tran_id"> Transaction Id <span class="text-danger">*</span></label> <div class="col-sm-9"> <input type="text" id="tran_id" placeholder="Enter Transaction Id After Payment" class="form-control" name="tran_id" required> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label no-padding-right" for="tran_id"> Payment Date <span class="text-danger">*</span></label> <div class="col-sm-9"> <input type="text" id="c_date" class="form-control" name="date" value="<?php echo e(date('Y-m-d')); ?>" /> </div> </div> <input class="hidden" type="text" name="pay_method" value="ROCKET"> <input class="hidden" type="text" name="payer_id" value="<?php echo e(Auth::user()->customer_id); ?>"> <input class="hidden" type="text" name="payer_role" value="<?php echo e(Auth::user()->role); ?>"> <input class="hidden" type="text" name="package_id" value="<?php echo e($package->id); ?>"> <div class="form-group"> <div class="col-sm-9"> <div class="btn-group pull-right"> <button type="submit" class="btn btn-primary btn-round">Submit Payment </button> </div> </div> </div> </div> </form> </div> <div id="nagad" class="tab-pane fade"> <p class="text-danger" style="font-weight: bold;line-height: 2.5;">নগদ আক্যাউন্ট থেকে এই <span class="label label-lg label-danger arrowed-right">01714966214</span> নাম্বারে নিচের <span class="label label-info label-white middle"> Pay Amount </span> কৃত টাকা সেন্ডমানি করুন । সেন্ডমানি সফল হলে <span class="label label-info label-white middle">Transaction Id </span> ঘরে ট্রানজেকসন আইডি বসিয়ে <span class="label label-info label-white middle"> Submit Payment </span> ক্লিক করুন । যে কোন প্রয়োজনে যোগাযোগ করুন - <strong><a href="https://www.facebook.com/mdredwanullah1996" target="_blank" title="Facebook">Facebook</a></strong></p> <form action="<?php echo e(route('store_payment')); ?>" class="form-horizontal" role="form" method="POST" style="margin-top:10px;"> <?php echo csrf_field(); ?> <div class="" style="margin-top:10px;"> <div class="form-group"> <label class="col-sm-3 control-label no-padding-right" for="h_name"> Payer Name <span class="text-danger">*</span></label> <div class="col-sm-9"> <input type="text" id="name" placeholder="Full Name" class="form-control" name="payer_name" value="<?php echo e(Auth::user()->name); ?>" readonly> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label no-padding-right" for="monthly_charge"> Pay Amount <span class="text-danger">*</span></label> <div class="col-sm-9"> <input type="text" id="pay_amount" placeholder="Monthly Bill Amount" class="form-control" name="pay_amount" value="<?php echo e($package->package_amount - $package->package_discount); ?>" readonly> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label no-padding-right" for="pay_account"> Payment Account <span class="text-danger">*</span></label> <div class="col-sm-9"> <input type="text" readonly id="pay_account" placeholder="01714966214" class="form-control" name="pay_account" value="01714966214"> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label no-padding-right" for="tran_id"> Transaction Id <span class="text-danger">*</span></label> <div class="col-sm-9"> <input type="text" id="tran_id" placeholder="Enter Transaction Id After Payment" class="form-control" name="tran_id" required> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label no-padding-right" for="tran_id"> Payment Date <span class="text-danger">*</span></label> <div class="col-sm-9"> <input type="text" id="c_date" class="form-control" name="date" value="<?php echo e(date('Y-m-d')); ?>" /> </div> </div> <input class="hidden" type="text" name="pay_method" value="NAGAD"> <input class="hidden" type="text" name="payer_id" value="<?php echo e(Auth::user()->customer_id); ?>"> <input class="hidden" type="text" name="payer_role" value="<?php echo e(Auth::user()->role); ?>"> <input class="hidden" type="text" name="package_id" value="<?php echo e($package->id); ?>"> <div class="form-group"> <div class="col-sm-9"> <div class="btn-group pull-right"> <button type="submit" class="btn btn-primary btn-round">Submit Payment </button> </div> </div> </div> </div> </form> </div> <div id="bkash" class="tab-pane fade active in"> <p class="text-danger" style="font-weight: bold;line-height: 2.5;">বিকাশ আক্যাউন্ট থেকে এই <span class="label label-lg label-danger arrowed-right">01883910225</span> নাম্বারে নিচের <span class="label label-info label-white middle"> Pay Amount </span> কৃত টাকা সেন্ডমানি করুন । সেন্ডমানি সফল হলে <span class="label label-info label-white middle">Transaction Id </span> ঘরে ট্রানজেকসন আইডি বসিয়ে <span class="label label-info label-white middle"> Submit Payment </span> ক্লিক করুন । যে কোন প্রয়োজনে যোগাযোগ করুন - <strong><a href="https://www.facebook.com/mdredwanullah1996" target="_blank" title="Facebook">Facebook</a></strong></p> <form action="<?php echo e(route('store_payment')); ?>" class="form-horizontal" role="form" method="POST" style="margin-top:10px;"> <?php echo csrf_field(); ?> <div class="" style="margin-top:10px;"> <div class="form-group"> <label class="col-sm-3 control-label no-padding-right" for="h_name"> Payer Name <span class="text-danger">*</span></label> <div class="col-sm-9"> <input type="text" id="name" placeholder="Full Name" class="form-control" name="payer_name" value="<?php echo e(Auth::user()->name); ?>" readonly> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label no-padding-right" for="monthly_charge"> Pay Amount <span class="text-danger">*</span></label> <div class="col-sm-9"> <input type="text" id="pay_amount" placeholder="Monthly Bill Amount" class="form-control" name="pay_amount" value="<?php echo e($package->package_amount - $package->package_discount); ?>" readonly> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label no-padding-right" for="pay_account"> Payment Account <span class="text-danger">*</span></label> <div class="col-sm-9"> <input type="text" readonly id="pay_account" placeholder="01883910225" class="form-control" name="pay_account" value="01883910225"> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label no-padding-right" for="tran_id"> Transaction Id <span class="text-danger">*</span></label> <div class="col-sm-9"> <input type="text" id="tran_id" placeholder="Enter Transaction Id After Payment" class="form-control" name="tran_id" required> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label no-padding-right" for="tran_id"> Payment Date <span class="text-danger">*</span></label> <div class="col-sm-9"> <input type="text" id="c_date" class="form-control" name="date" value="<?php echo e(date('Y-m-d')); ?>" /> </div> </div> <input class="hidden" type="text" name="pay_method" value="BKASH"> <input class="hidden" type="text" name="payer_id" value="<?php echo e(Auth::user()->customer_id); ?>"> <input class="hidden" type="text" name="payer_role" value="<?php echo e(Auth::user()->role); ?>"> <input class="hidden" type="text" name="package_id" value="<?php echo e($package->id); ?>"> <div class="form-group"> <div class="col-sm-9"> <div class="btn-group pull-right"> <button type="submit" class="btn btn-primary btn-round">Submit Payment </button> </div> </div> </div> </div> </form> </div> </div> </div> </div> <div class="col-sm-3"></div> </div> <?php $__env->stopSection(); ?> <?php echo $__env->make('layouts.app', \Illuminate\Support\Arr::except(get_defined_vars(), ['__data', '__path']))->render(); ?><?php /**PATH /home/rejoandoctor/public_html/resources/views/Prescribe/payment_content.blade.php ENDPATH**/ ?>