Open-ILS/src/templates/staff/circ/patron/t_cc_payment_dialog.tt2

   1 <div class="modal-header">
   2   <button type="button" class="close"
   3     ng-click="cancel()" aria-hidden="true">&times;</button>
   4   <h4 class="modal-title">
   5     [% l('Credit Card Information') %]
   6   </h4>
   7 </div>
   8 <div class="modal-body tight-vert-form" id="patron-pay-by-credit-form">
   9   <div class="panel panel-default">
  10     <div class="panel-heading">[% l('Credit Card Info') %]</div>
  11     <div class="panel-body">
  12       <div class="row form-group">
  13         <div class="col-md-4"><label>[% l('Process Where?') %]</label></div>
  14         <div class="col-md-8">
  15           <select class="form-control" ng-model="context.cc.where_process">
  16             <option value='1'>
  17               [% l('Process payment through Evergreen') %]</option>
  18             <option value='0'>
  19               [% l('Record externally processed payment') %]</option>
  20           </select>
  21         </div>
  22       </div>
  23       <!-- wrapper div for internal CC processing fields -->
  24       <div ng-if="context.cc.where_process == '1'">
  25         <div class="row form-group">
  26           <div class="col-md-4"><label>[% l('Credit Card Number') %]</label></div>
  27           <div class="col-md-8">
  28             <input type='text' class="form-control" ng-model="context.cc.number"/>
  29           </div>
  30         </div>
  31         <div class="row form-group">
  32           <div class="col-md-4"><label>[% l('Expire Month') %]</label></div>
  33           <div class="col-md-8">
  34             <input type='number' class="form-control" ng-model="context.cc.expire_month"/>
  35           </div>
  36         </div>
  37         <div class="row form-group">
  38           <div class="col-md-4"><label>[% l('Expire Year') %]</label></div>
  39           <div class="col-md-8">
  40             <input type='number' class="form-control" ng-model="context.cc.expire_year"/>
  41           </div>
  42         </div>
  43       </div><!--cc-internal-wrapper-->
  44       <div ng-if="context.cc.where_process == '0'">
  45         <div class="row form-group">
  46           <div class="col-md-4"><label>[% l('Approval Code') %]</label></div>
  47           <div class="col-md-8">
  48             <input type='text' class="form-control"
  49               required ng-model="context.cc.approval_code"/>
  50           </div>
  51         </div>
  52       </div><!--cc-external-wrapper-->
  53     </div><!--panel-body-->
  54   </div><!--panel-->
  55   <div class="panel panel-default">
  56     <div class="panel-heading">[% l('Optional Fields') %]</div>
  57     <div class="panel-body">
  58       <div class="row form-group">
  59         <div class="col-md-4"><label>[% l('Billing Name (first)') %]</label></div>
  60         <div class="col-md-8">
  61           <input type='text' class="form-control"
  62             ng-model="context.cc.billing_first"/>
  63         </div>
  64       </div>
  65       <div class="row form-group">
  66         <div class="col-md-4"><label>[% l('Billing Name (last)') %]</label></div>
  67         <div class="col-md-8">
  68           <input type='text' class="form-control"
  69             ng-model="context.cc.billing_last"/>
  70         </div>
  71       </div>
  72       <div ng-if="context.cc.where_process == '1'">
  73         <div class="row form-group">
  74           <div class="col-md-4"><label>[% l('Address') %]</label></div>
  75           <div class="col-md-8">
  76             <input type='text' class="form-control"
  77               ng-model="context.cc.billing_address"/>
  78           </div>
  79         </div>
  80         <div class="row form-group">
  81           <div class="col-md-4"><label>[% l('City, town or village') %]</label></div>
  82           <div class="col-md-8">
  83             <input type='text' class="form-control"
  84               ng-model="context.cc.billing_city"/>
  85           </div>
  86         </div>
  87         <div class="row form-group">
  88           <div class="col-md-4"><label>[% l('State or province') %]</label></div>
  89           <div class="col-md-8">
  90             <input type='text' class="form-control"
  91               ng-model="context.cc.billing_state"/>
  92           </div>
  93         </div>
  94         <div class="row form-group">
  95           <div class="col-md-4"><label>[% l('ZIP or postal code') %]</label></div>
  96           <div class="col-md-8">
  97             <input type='text' class="form-control"
  98               ng-model="context.cc.billing_zip"/>
  99           </div>
 100         </div>
 101       </div><!--cc-internal-wrapper-->
 102       <div class="row form-group">
 103         <div class="col-md-4"><label>[% l('Note') %]</label></div>
 104         <div class="col-md-8">
 105           <textarea rows="2" type='text' class="form-control"
 106             ng-model="context.cc.note"></textarea>
 107         </div>
 108       </div>
 109     </div><!--panel-body-->
 110   </div><!--panel-->
 111 </div><!--modal-body-->
 112 <div class="modal-footer">
 113   <button class="btn btn-primary" ng-click="ok()" ng-disabled="context.cc.where_process == 0 && !context.cc.approval_code">[% l('Submit') %]</button>
 114   <button class="btn btn-warning" ng-click="cancel()">[% l('Cancel') %]</button>
 115 </div>
 116