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