<?php $page = 'product-checkout'; ?>
@extends('layout.mainlayout')
@section('content')
    @component('components.breadcrumb')
        @slot('title')
        Pharmacy
        @endslot
        @slot('li_1')
            Checkout
        @endslot
        @slot('li_2')
        Checkout
    @endslot
    @endcomponent
    <!-- Page Content -->
    <div class="content">
        <div class="container">
            <div class="row">
                <div class="col-md-6 col-lg-7">
                    <div class="card">
                        <div class="card-header">
                            <h3 class="card-title">Billing details</h3>
                        </div>
                        <div class="card-body">
                            <!-- Checkout Form -->
                            <form action="{{ url('payment-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="javascript:;">Click here to login</a>
                                    </div>
                                </div>
                                <!-- /Personal Information -->

                                <!-- Shipping Details -->
                                <div class="info-widget">
                                    <h4 class="card-title">Shipping Details</h4>
                                    <div class="terms-accept">
                                        <div class="custom-checkbox">
                                            <input type="checkbox" id="terms_accept">
                                            <label for="terms_accept">Ship to a different address?</label>
                                        </div>
                                    </div>
                                    <div class="mb-3 card-label">
                                        <label class="ps-0 ms-0 mb-2">Order notes (Optional)</label>
                                        <textarea rows="5" class="form-control" name="shipping"></textarea>
                                    </div>
                                </div>
                                <!-- /Shipping Details -->

                                <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_accept1">
                                            <label for="terms_accept1">I have read and accept <a href="{{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-6 col-lg-5 theiaStickySidebar">

                    <!-- Booking Summary -->
                    <div class="card booking-card">
                        <div class="card-header">
                        <h3 class="card-title">Your Order</h3>
                        </div>
                        <div class="card-body">
                        <div class="table-responsive">
                        <table class="table table-center mb-0">
                        <tbody><tr>
                        <th>Product</th>
                        <th class="text-end">Total</th>
                        </tr>
                        </tbody><tbody>
                        <tr>
                        <td>Safi Natural Blood Purifier Syrup 200 ml Manufactured By Hamdard (Wakf) Laboratories</td>
                        <td class="text-end">$200</td>
                        </tr>
                        <tr>
                        <td>Safi Natural Blood Purifier Syrup 200 ml</td>
                        <td class="text-end">$200</td>
                        </tr>
                        </tbody>
                        </table>
                        </div>
                        <div class="booking-summary pt-5">
                        <div class="booking-item-wrap">
                        <ul class="booking-date d-block pb-0">
                        <li>Subtotal <span>$5,877.00</span></li>
                        <li>Shipping <span>$25.00</span></li>
                        </ul>
                        <ul class="booking-fee">
                        <li>Tax <span>$0.00</span></li>
                        </ul>
                        <div class="booking-total">
                        <ul class="booking-total-list">
                        <li>
                        <span>Total</span>
                        <span class="total-cost">$160</span>
                        </li>
                        <li>
                        </li></ul>
                        </div>
                        </div>
                        </div>
                        </div>
                        </div>
                    <!-- /Booking Summary -->

                </div>
            </div>

        </div>

    </div>
    <!-- /Page Content -->
@endsection
