<?php $page = 'checkout'; ?>

<?php $__env->startSection('content'); ?>
    <?php $__env->startComponent('components.breadcrumb'); ?>
        <?php $__env->slot('title'); ?>
        Patient
        <?php $__env->endSlot(); ?>
        <?php $__env->slot('li_1'); ?>
            Checkout
        <?php $__env->endSlot(); ?>
        <?php $__env->slot('li_2'); ?>
            Checkout
        <?php $__env->endSlot(); ?>
    <?php echo $__env->renderComponent(); ?>
    <!-- Page Content -->
    <div class="content">
        <div class="container">
            <div class="row">
                <div class="col-md-7 col-lg-8">
                    <div class="card">
                        <div class="card-body">
                            <!-- Checkout Form -->
                            <form action="<?php echo e(url('booking-success')); ?>">
                                <!-- Personal Information -->
                                <div class="info-widget">
                                    <h4 class="card-title">Personal Information</h4>
                                    <div class="row">
                                        <div class="col-md-6 col-sm-12">
                                            <div class="mb-3 card-label">
                                                <label class="mb-2">First Name</label>
                                                <input class="form-control" type="text">
                                            </div>
                                        </div>
                                        <div class="col-md-6 col-sm-12">
                                            <div class="mb-3 card-label">
                                                <label class="mb-2">Last Name</label>
                                                <input class="form-control" type="text">
                                            </div>
                                        </div>
                                        <div class="col-md-6 col-sm-12">
                                            <div class="mb-3 card-label">
                                                <label class="mb-2">Email</label>
                                                <input class="form-control" type="email">
                                            </div>
                                        </div>
                                        <div class="col-md-6 col-sm-12">
                                            <div class="mb-3 card-label">
                                                <label class="mb-2">Phone</label>
                                                <input class="form-control" type="text">
                                            </div>
                                        </div>
                                    </div>
                                    <div class="exist-customer">Existing Customer? <a href="<?php echo e(url('login')); ?>">Click here to login</a>
                                    </div>
                                </div>
                                <!-- /Personal Information -->

                                <div class="payment-widget">
                                    <h4 class="card-title">Payment Method</h4>

                                    <!-- Credit Card Payment -->
                                    <div class="payment-list">
                                        <label class="payment-radio credit-card-option">
                                            <input type="radio" name="radio" checked>
                                            <span class="checkmark"></span>
                                            Credit card
                                        </label>
                                        <div class="row">
                                            <div class="col-md-6">
                                                <div class="mb-3 card-label">
                                                    <label for="card_name">Name on Card</label>
                                                    <input class="form-control" id="card_name" type="text">
                                                </div>
                                            </div>
                                            <div class="col-md-6">
                                                <div class="mb-3 card-label">
                                                    <label for="card_number">Card Number</label>
                                                    <input class="form-control" id="card_number"
                                                        placeholder="1234  5678  9876  5432" type="text">
                                                </div>
                                            </div>
                                            <div class="col-md-4">
                                                <div class="mb-3 card-label">
                                                    <label for="expiry_month">Expiry Month</label>
                                                    <input class="form-control" id="expiry_month" placeholder="MM"
                                                        type="text">
                                                </div>
                                            </div>
                                            <div class="col-md-4">
                                                <div class="mb-3 card-label">
                                                    <label for="expiry_year">Expiry Year</label>
                                                    <input class="form-control" id="expiry_year" placeholder="YY"
                                                        type="text">
                                                </div>
                                            </div>
                                            <div class="col-md-4">
                                                <div class="mb-3 card-label">
                                                    <label for="cvv">CVV</label>
                                                    <input class="form-control" id="cvv" type="text">
                                                </div>
                                            </div>
                                        </div>
                                    </div>
                                    <!-- /Credit Card Payment -->

                                    <!-- Paypal Payment -->
                                    <div class="payment-list">
                                        <label class="payment-radio paypal-option">
                                            <input type="radio" name="radio">
                                            <span class="checkmark"></span>
                                            Paypal
                                        </label>
                                    </div>
                                    <!-- /Paypal Payment -->

                                    <!-- Terms Accept -->
                                    <div class="terms-accept">
                                        <div class="custom-checkbox">
                                            <input type="checkbox" id="terms_accept">
                                            <label for="terms_accept">I have read and accept <a href="<?php echo e(url('terms-condition')); ?>">Terms &amp;
                                                    Conditions</a></label>
                                        </div>
                                    </div>
                                    <!-- /Terms Accept -->

                                    <!-- Submit Section -->
                                    <div class="submit-section mt-4">
                                        <button type="submit" class="btn btn-primary submit-btn">Confirm and Pay</button>
                                    </div>
                                    <!-- /Submit Section -->

                                </div>
                            </form>
                            <!-- /Checkout Form -->

                        </div>
                    </div>

                </div>

                <div class="col-md-5 col-lg-4 theiaStickySidebar">

                    <!-- Booking Summary -->
                    <div class="card booking-card">
                        <div class="card-header">
                            <h4 class="card-title">Booking Summary</h4>
                        </div>
                        <div class="card-body">

                            <!-- Booking Doctor Info -->
                            <div class="booking-doc-info">
                                <a href="<?php echo e(url('doctor-profile')); ?>" class="booking-doc-img">
                                    <img src="<?php echo e(URL::asset('/assets/img/doctors/doctor-thumb-02.jpg')); ?>" alt="User Image">
                                </a>
                                <div class="booking-info">
                                    <h4><a href="<?php echo e(url('doctor-profile')); ?>">Dr. Darren Elder</a></h4>
                                    <div class="rating">
                                        <i class="fas fa-star filled"></i>
                                        <i class="fas fa-star filled"></i>
                                        <i class="fas fa-star filled"></i>
                                        <i class="fas fa-star filled"></i>
                                        <i class="fas fa-star"></i>
                                        <span class="d-inline-block average-rating">35</span>
                                    </div>
                                    <div class="clinic-details">
                                        <p class="doc-location"><i class="fas fa-map-marker-alt"></i> Newyork, USA</p>
                                    </div>
                                </div>
                            </div>
                            <!-- Booking Doctor Info -->

                            <div class="booking-summary">
                                <div class="booking-item-wrap">
                                    <ul class="booking-date">
                                        <li>Date :<span>14 Nov 2023</span></li>
                                        <li>Time :<span>10:00 AM</span></li>
                                    </ul>
                                    <ul class="booking-fee">
                                        <li>Consulting Fee <span>$100</span></li>
                                        <li>Booking Fee <span>$10</span></li>
                                        <li>Video Call <span>$50</span></li>
                                    </ul>
                                    <div class="booking-total">
                                        <ul class="booking-total-list">
                                            <li>
                                                <span>Total</span>
                                                <span class="total-cost">$160</span>
                                            </li>
                                        </ul>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <!-- /Booking Summary -->

                </div>
            </div>

        </div>

    </div>
    <!-- /Page Content -->
<?php $__env->stopSection(); ?>

<?php echo $__env->make('layout.mainlayout', \Illuminate\Support\Arr::except(get_defined_vars(), ['__data', '__path']))->render(); ?><?php /**PATH C:\xampp\htdocs\doccure\laravel\template\resources\views/checkout.blade.php ENDPATH**/ ?>