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<div class="row">
    <div class="col-md-12">
        <div class="form-group">
            <p style="font-size: 12px;"><b>$mobileInsurancePlan.getPlanName() - ($mobileInsurancePlan.getProviderName()
                )</b> $mobileInsurancePlan.getDuration() - ($mobileInsurancePlan.getPremium()) &nbsp;<button
                    class="btn btn-sm btn-success pull-right order-payment-status" data-orderid="$fofoOrder.getId()"
                    style="font-size: 11px;margin-top:-5px;">Payment Status
            </button>
            </p>


        </div>
    </div>
    <hr style="margin:8px 0;">
    <div class="col-md-4">
        <div class="form-group">
            <label>Ram</label>
            <input type="text" class="form-control ram" placeholder="ram">
        </div>
    </div>
    <div class="col-md-4">
        <div class="form-group">
            <label>Memory</label>
            <input type="text" class="form-control memory" placeholder="memory">
        </div>
    </div>
    <div class="col-md-4">
        <div class="form-group">
            <label>MFG Date</label>
            <input type="date" class="form-control wmfgDate" placeholder="MFG">
        </div>
    </div>
    <div class="col-md-3">
        <div class="form-group">
            <label>Serial Number</label>
            <input type="text" class="form-control serial-number serial-number-input" placeholder="Serial Number">
        </div>
    </div>
    <div class="col-md-3">
        <div class="form-group">
            <label>Customer Email</label>
            #if ($customer.getEmailId())
                <input type="email" class="form-control customerEmail" placeholder="Email"
                       value="$customer.getEmailId()">
            #else
                <input type="email" class="form-control customerEmail" placeholder="Email">
            #end
        </div>
    </div>
    <div class="col-md-3">
        <div class="form-group">
            <label>Customer Dob</label>
            #if ($customer.getDob())
                <input type="date" class="form-control dob" placeholder="DOB" value="$customer.getDob()">
            #else
                <input type="date" class="form-control dob" placeholder="DOB">
            #end
        </div>
    </div>
    <div class="col-md-3">
        <div class="form-group">
            <label>Gender</label>
            #if ($customer.getGender())
                <select class="form-control gender">
                    <option value="$customer.getGender()">$customer.getGender()</option>
                </select>
            #else
                <select class="form-control gender">
                    <option value="">Select Option</option>
                    <option value="Male">Male</option>
                    <option value="Female">Female</option>
                </select>
            #end
        </div>
    </div>

    <input type="hidden" class="order-item-id" value="$fofoOrderItem.getId()">
    <input type="hidden" class="order-id" value="$fofoOrder.getId()">
    <input type="hidden" class="insurance-id" value="$mobileInsurancePlan.getProductId()">
    <input type="hidden" class="insurance-dp" value="$mobileInsurancePlan.getDp()">
    <input type="hidden" class="insurance-premium" value="$mobileInsurancePlan.getPremium()">
    <input type="hidden" class="insurance-amount" value="$mobileInsurancePlan.getPremium()">
    <input type="hidden" class="insurance-description" value="$mobileInsurancePlan.getProductDescription()">
    <input type="hidden" class="insurance-plan-name" value="$mobileInsurancePlan.getPlanName()">
    <input type="hidden" class="customer-mobile-number" value="$customer.getMobileNumber()">
    <input type="hidden" class="customer-first-name" value="$customer.getFirstName()">
    <input type="hidden" class="customer-email-id" value="$customer.getEmailId()">
    <input type="hidden" class="customer-serial-number" value="$serialNumber">

    <div class="clearfix"></div>
    <hr style="margin:8px 0;">
    <div class="col-md-12 well" style="padding: 10px; max-height: 200px;overflow-y: auto;margin-bottom: 0;">
        <button type="button" class="btn btn-sm btn-primary add-new-address-btn pull-right"
                style="font-size: 10px;margin-bottom: 10px;" data-customerid="$customer.getId()"
                data-orderid="$fofoOrder.getId()">Add New Address
        </button>
        <table class="table table-striped table-bordered address-table" style="width: 100%">
            <thead>
            <tr>
                <th>Name</th>
                <th>Address Lines</th>
                <th>City</th>
                <th>State</th>
                <th>Pin</th>
                <th>Mobile</th>
                <th>Action</th>
            </tr>
            </thead>
            <tbody>
                #foreach($address in $customerAddress)
                <tr>
                    <td>$address.getName()</td>
                    <td>$address.getLine1() $address.getLine2()</td>
                    <td>$address.getCity()</td>
                    <td>$address.getState()</td>
                    <td>$address.getPinCode()</td>
                    <td>$address.getPhoneNumber()</td>
                    <td><a href="javascript:void(0)" class="select-customer-address" data-addressid="$address.getId()"
                           data-orderid="$fofoOrder.getId()">Select Address</a></td>
                </tr>
                #end
            </tbody>

        </table>

    </div>
    <div class="clearfix"></div>
    <hr style="margin:8px 0;">
    <div class="col-md-12">
        <div class="form-group">
            <button type="button" class="btn btn-info btn-sm create-insurance-mk pull-right mr-lr-5"
                    style="display: none;">Create Insurance
            </button>
            <button type="button" class="btn btn-success btn-sm payment-link-mk pull-right mr-lr-5">Send Payment Link
            </button>
        </div>
    </div>
</div>