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">
   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('Credit Card Type') %]</label></div>
  47           <div class="col-md-8">
  48             <select class="form-control" ng-model="context.cc.type">
  49               <option value='VISA'>[% l('VISA') %]</option>
  50               <option value='MasterCard'>[% l('Mastercard') %]</option>
  51               <option value='American Express'>[% l('American Express') %]</option>
  52               <option value='Discover'>[% l('Discover') %]</option>
  53               <option value='Other'>[% l('Other') %]</option>
  54             </select>
  55           </div>
  56         </div>
  57         <div class="row form-group">
  58           <div class="col-md-4"><label>[% l('Approval Code') %]</label></div>
  59           <div class="col-md-8">
  60             <input type='text' class="form-control" ng-model="context.cc.approval_code"/>
  61           </div>
  62         </div>
  63       </div><!--cc-external-wrapper-->
  64     </div><!--panel-body-->
  65   </div><!--panel-->
  66   <div class="panel panel-default">
  67     <div class="panel-heading">[% l('Optional Fields') %]</div>
  68     <div class="panel-body">
  69       <div class="row form-group">
  70         <div class="col-md-4"><label>[% l('Billing Name (first)') %]</label></div>
  71         <div class="col-md-8">
  72           <input type='text' class="form-control"
  73             ng-model="context.cc.billing_first"/>
  74         </div>
  75       </div>
  76       <div class="row form-group">
  77         <div class="col-md-4"><label>[% l('Billing Name (last)') %]</label></div>
  78         <div class="col-md-8">
  79           <input type='text' class="form-control"
  80             ng-model="context.cc.billing_last"/>
  81         </div>
  82       </div>
  83       <div ng-if="context.cc.where_process == '1'">
  84         <div class="row form-group">
  85           <div class="col-md-4"><label>[% l('Address') %]</label></div>
  86           <div class="col-md-8">
  87             <input type='text' class="form-control"
  88               ng-model="context.cc.billing_address"/>
  89           </div>
  90         </div>
  91         <div class="row form-group">
  92           <div class="col-md-4"><label>[% l('City, town or village') %]</label></div>
  93           <div class="col-md-8">
  94             <input type='text' class="form-control"
  95               ng-model="context.cc.billing_city"/>
  96           </div>
  97         </div>
  98         <div class="row form-group">
  99           <div class="col-md-4"><label>[% l('State or province') %]</label></div>
 100           <div class="col-md-8">
 101             <input type='text' class="form-control"
 102               ng-model="context.cc.billing_state"/>
 103           </div>
 104         </div>
 105         <div class="row form-group">
 106           <div class="col-md-4"><label>[% l('ZIP or postal code') %]</label></div>
 107           <div class="col-md-8">
 108             <input type='text' class="form-control"
 109               ng-model="context.cc.billing_zip"/>
 110           </div>
 111         </div>
 112       </div><!--cc-internal-wrapper-->
 113       <div class="row form-group">
 114         <div class="col-md-4"><label>[% l('Note') %]</label></div>
 115         <div class="col-md-8">
 116           <textarea rows="2" type='text' class="form-control"
 117             ng-model="context.cc.note"></textarea>
 118         </div>
 119       </div>
 120     </div><!--panel-body-->
 121   </div><!--panel-->
 122 </div><!--modal-body-->
 123 <div class="modal-footer">
 124   <button class="btn btn-primary" ng-click="ok()">[% l('Submit') %]</button>
 125   <button class="btn btn-warning" ng-click="cancel()">[% l('Cancel') %]</button>
 126 </div>
 127