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<div class="row">
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<div class="col-md-12">
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<div class="form-group">
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<p style="font-size: 12px;"><b>$mobileInsurancePlan.getPlanName() - ($mobileInsurancePlan.getProviderName()
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)</b> $mobileInsurancePlan.getDuration() - ($mobileInsurancePlan.getPremium()) <button
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class="btn btn-sm btn-success pull-right order-payment-status" data-orderid="$fofoOrder.getId()"
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style="font-size: 11px;margin-top:-5px;">Payment Status
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</button>
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</p>
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</div>
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</div>
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<hr style="margin:8px 0;">
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<div class="col-md-4">
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<div class="form-group">
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<label>Ram</label>
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<input type="text" class="form-control ram" placeholder="ram">
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</div>
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</div>
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<div class="col-md-4">
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<div class="form-group">
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<label>Memory</label>
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<input type="text" class="form-control memory" placeholder="memory">
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</div>
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</div>
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<div class="col-md-4">
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<div class="form-group">
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<label>MFG Date</label>
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<input type="date" class="form-control wmfgDate" placeholder="MFG">
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</div>
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</div>
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<div class="col-md-3">
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<div class="form-group">
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<label>Serial Number</label>
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<input type="text" class="form-control serial-number serial-number-input" placeholder="Serial Number">
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</div>
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</div>
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<div class="col-md-3">
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<div class="form-group">
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<label>Customer Email</label>
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#if ($customer.getEmailId())
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ranu |
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<input type="email" class="form-control customerEmail" placeholder="Email"
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value="$customer.getEmailId()">
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#else
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ranu |
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<input type="email" class="form-control customerEmail" placeholder="Email">
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ranu |
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#end
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</div>
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</div>
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<div class="col-md-3">
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<div class="form-group">
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<label>Customer Dob</label>
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#if ($customer.getDob())
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<input type="date" class="form-control dob" placeholder="DOB" value="$customer.getDob()">
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#else
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<input type="date" class="form-control dob" placeholder="DOB">
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#end
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</div>
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</div>
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<div class="col-md-3">
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<div class="form-group">
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<label>Gender</label>
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#if ($customer.getGender())
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<select class="form-control gender">
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<option value="$customer.getGender()">$customer.getGender()</option>
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</select>
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#else
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<select class="form-control gender">
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<option value="">Select Option</option>
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<option value="Male">Male</option>
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<option value="Female">Female</option>
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</select>
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#end
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</div>
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</div>
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<input type="hidden" class="order-item-id" value="$fofoOrderItem.getId()">
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<input type="hidden" class="order-id" value="$fofoOrder.getId()">
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<input type="hidden" class="insurance-id" value="$mobileInsurancePlan.getProductId()">
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<input type="hidden" class="insurance-dp" value="$mobileInsurancePlan.getDp()">
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<input type="hidden" class="insurance-premium" value="$mobileInsurancePlan.getPremium()">
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<input type="hidden" class="insurance-amount" value="$mobileInsurancePlan.getPremium()">
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<input type="hidden" class="insurance-description" value="$mobileInsurancePlan.getProductDescription()">
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<input type="hidden" class="insurance-plan-name" value="$mobileInsurancePlan.getPlanName()">
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<input type="hidden" class="customer-mobile-number" value="$customer.getMobileNumber()">
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<input type="hidden" class="customer-first-name" value="$customer.getFirstName()">
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<input type="hidden" class="customer-email-id" value="$customer.getEmailId()">
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<input type="hidden" class="customer-serial-number" value="$serialNumber">
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<div class="clearfix"></div>
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<hr style="margin:8px 0;">
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<div class="col-md-12 well" style="padding: 10px; max-height: 200px;overflow-y: auto;margin-bottom: 0;">
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<button type="button" class="btn btn-sm btn-primary add-new-address-btn pull-right"
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style="font-size: 10px;margin-bottom: 10px;" data-customerid="$customer.getId()"
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data-orderid="$fofoOrder.getId()">Add New Address
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</button>
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<table class="table table-striped table-bordered address-table" style="width: 100%">
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<thead>
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<tr>
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<th>Name</th>
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<th>Address Lines</th>
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<th>City</th>
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<th>State</th>
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<th>Pin</th>
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<th>Mobile</th>
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<th>Action</th>
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</tr>
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</thead>
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<tbody>
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#foreach($address in $customerAddress)
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<tr>
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<td>$address.getName()</td>
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<td>$address.getLine1() $address.getLine2()</td>
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<td>$address.getCity()</td>
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<td>$address.getState()</td>
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<td>$address.getPinCode()</td>
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<td>$address.getPhoneNumber()</td>
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<td><a href="javascript:void(0)" class="select-customer-address" data-addressid="$address.getId()"
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data-orderid="$fofoOrder.getId()">Select Address</a></td>
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</tr>
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#end
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</tbody>
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</table>
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</div>
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<div class="clearfix"></div>
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<hr style="margin:8px 0;">
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<div class="col-md-12">
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<div class="form-group">
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ranu |
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<button type="button" class="btn btn-info btn-sm create-insurance-mk pull-right mr-lr-5"
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style="display: none;">Create Insurance
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</button>
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<button type="button" class="btn btn-success btn-sm payment-link-mk pull-right mr-lr-5">Send Payment Link
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</button>
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</div>
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</div>
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</div>
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