<?php $this->load->view('admin/includes/head'); ?>
<?php $this->load->view('admin/includes/sidebar'); ?>
<?php $this->load->view('admin/includes/topbar'); ?>
<!-- Main content-->

<div class="container">
	<div class="row p-4 ">
		<div class="col-md-12 mx-auto d-block card shadow-lg p-5 my-2">
			<?= form_open(base_url('admin/request-refund-payment/'.base64_encode($payment_data[0]['insertedId']).'/'.base64_encode($payment_data[0]['memberId'])),'method="post"'); ?>

			<fieldset class="border-2">
				<legend  class="legend-outer  float-none w-auto"> Payment Refund Form ( Order No#: <?=$payment_data[0]['batchNo']?>)</legend>

				<div class="row">
					<div class="col-md-12">
						<fieldset class="border">
							<legend  class="legend-inner float-none w-auto required">Service Name</legend>
							<div class="input-group">
								<i class="fa fa-place-of-worship fa2"></i>
								<input type="text" class="form-control border-dark mb-1 " name="serviceName" id="serviceName" placeholder="Service Date" value="<?=set_value('serviceName', @$payment_data[0]['paymentsData'][0]['ServiceSetup'])?>"required readonly>
								<input type="text" name="orderno" value="<?=$payment_data[0]['batchNo']?>"hidden>
							</div>
						</fieldset>
					</div>
					<div class="col-md-4">
						<fieldset class="border">
							<legend  class="legend-inner float-none w-auto required">Service Date</legend>
							<div class="input-group">
								<i class="fa fa-calendar fa2"></i>
								<input type="text" class="form-control border-dark mb-1 " name="serviceDate" id="serviceDate" placeholder="Service Date" value="<?=set_value('serviceDate', @$payment_data[0]['paymentsData'][0]['serviceDate'])?>"required readonly>
							</div>
						</fieldset>
					</div>
					<div class="col-md-2">
						<fieldset class="border">
							<legend  class="legend-inner float-none w-auto required">Quantity</legend>
							<div class="input-group">
								<input type="text" class="form-control border-dark mb-1 " name="serviceQty" id="serviceQty" placeholder="Service Quantity" value="<?=set_value('serviceQty', @$payment_data[0]['paymentsData'][0]['qty'])?>"required readonly>
							</div>
						</fieldset>
					</div>
					

					<div class="col-md-3">
						<fieldset class="border">
							<legend  class="legend-inner float-none w-auto required">Service Amount</legend>
							<div class="input-group">
								<i class="fa fa-dollar fa2"></i>
								<input type="text" class="form-control border-dark mb-1 " name="serviceAmount" id="serviceAmount" placeholder="Service Amount" value="<?=set_value('serviceAmount', @price_format($payment_data[0]['paymentsData'][0]['serviceAmount'], 2))?>"required readonly>
							</div>
						</fieldset>
					</div>
					<div class="col-md-3">
						<fieldset class="border">
							<legend  class="legend-inner float-none w-auto required">Refundable Amount</legend>
							<div class="input-group">
								<i class="fa fa-dollar fa2"></i>
								<input type="text" class="form-control border-dark mb-1 " name="RefundableAmount" id="RefundableAmount" placeholder="Refundable Amount" value="<?=set_value('RefundableAmount', @price_format($payment_data[0]['paymentsData'][0]['serviceAmount'], 2))?>"required readonly>
							</div>
						</fieldset>
					</div>


					<div class="col-md-12">
						<fieldset class="border">
							<legend  class="legend-inner float-none w-auto required">Reason Of Refund</legend>
							<div class="input-group">
								<textarea class="form-control border-dark mb-1 " name="reason" id="reason" placeholder="Describe Your Reason of Refund" required></textarea>
							</div>
						</fieldset>
					</div>
					<center><button type="submit" class="btn btn-success mb-3">Request Refund</button></center>
				</div>
			</fieldset>
		</form>
	</div>

</div>
</div>
</div>
<!-- End Main content--> 
<script>

	$(document).ready(function() {
		$("#heading").text('Payment Refund Form');
	} );

</script>
</body>
</html>
