Your IP : 3.16.135.225
{{ header }}
<div id="account-return" class="container">
<ul class="breadcrumb">
{% for breadcrumb in breadcrumbs %}
<li class="breadcrumb-item"><a href="{{ breadcrumb.href }}"> {{ breadcrumb.text }}</a></li>
{% endfor %}
</ul>
<div class="row">{{ column_left }}
<div id="content" class="col"> {{ content_top }}
<h1>{{ heading_title }}</h1>
<p>{{ text_description }}</p>
<form id="form-return" action="{{ save }}" method="post" data-oc-toggle="ajax">
<fieldset>
<legend>{{ text_order }}</legend>
<div class="row mb-3 required">
<label for="input-firstname" class="col-sm-2 col-form-label">{{ entry_firstname }}</label>
<div class="col-sm-10">
<input type="text" name="firstname" value="{{ firstname }}" placeholder="{{ entry_firstname }}" id="input-firstname" class="form-control"/>
<div id="error-firstname" class="invalid-feedback"></div>
</div>
</div>
<div class="row mb-3 required">
<label for="input-lastname" class="col-sm-2 col-form-label">{{ entry_lastname }}</label>
<div class="col-sm-10">
<input type="text" name="lastname" value="{{ lastname }}" placeholder="{{ entry_lastname }}" id="input-lastname" class="form-control"/>
<div id="error-lastname" class="invalid-feedback"></div>
</div>
</div>
<div class="row mb-3 required">
<label for="input-email" class="col-sm-2 col-form-label">{{ entry_email }}</label>
<div class="col-sm-10">
<input type="text" name="email" value="{{ email }}" placeholder="{{ entry_email }}" id="input-email" class="form-control"/>
<div id="error-email" class="invalid-feedback"></div>
</div>
</div>
<div class="row mb-3 required">
<label for="input-telephone" class="col-sm-2 col-form-label">{{ entry_telephone }}</label>
<div class="col-sm-10">
<input type="text" name="telephone" value="{{ telephone }}" placeholder="{{ entry_telephone }}" id="input-telephone" class="form-control"/>
<div id="error-telephone" class="invalid-feedback"></div>
</div>
</div>
<div class="row mb-3 required">
<label for="input-order-id" class="col-sm-2 col-form-label">{{ entry_order_id }}</label>
<div class="col-sm-10">
<input type="text" name="order_id" value="{{ order_id }}" placeholder="{{ entry_order_id }}" id="input-order-id" class="form-control"/>
<div id="error-order-id" class="invalid-feedback"></div>
</div>
</div>
<div class="row mb-3">
<label for="input-date-ordered" class="col-sm-2 col-form-label">{{ entry_date_ordered }}</label>
<div class="col-sm-10 col-md-4">
<div class="input-group">
<input type="text" name="date_ordered" value="{{ date_ordered }}" placeholder="{{ entry_date_ordered }}" id="input-date-ordered" class="form-control date"/>
<div class="input-group-text"><i class="fas fa-calendar"></i></div>
</div>
</div>
</div>
</fieldset>
<fieldset>
<legend>{{ text_product }}</legend>
<div class="row mb-3 required">
<label for="input-product" class="col-sm-2 col-form-label">{{ entry_product }}</label>
<div class="col-sm-10">
<input type="text" name="product" value="{{ product }}" placeholder="{{ entry_product }}" id="input-product" class="form-control"/> <input type="hidden" name="product_id" value="{{ product_id }}"/>
<div id="error-product" class="invalid-feedback"></div>
</div>
</div>
<div class="row mb-3 required">
<label for="input-model" class="col-sm-2 col-form-label">{{ entry_model }}</label>
<div class="col-sm-10">
<input type="text" name="model" value="{{ model }}" placeholder="{{ entry_model }}" id="input-model" class="form-control"/>
<div id="error-model" class="invalid-feedback"></div>
</div>
</div>
<div class="row mb-3">
<label for="input-quantity" class="col-sm-2 col-form-label">{{ entry_quantity }}</label>
<div class="col-sm-10">
<input type="text" name="quantity" value="1" placeholder="{{ entry_quantity }}" id="input-quantity" class="form-control"/>
</div>
</div>
<div class="row mb-3 required">
<label class="col-sm-2 col-form-label">{{ entry_reason }}</label>
<div class="col-sm-10">
<div id="input-reason">
{% for return_reason in return_reasons %}
<div class="form-check">
<input type="radio" name="return_reason_id" value="{{ return_reason.return_reason_id }}" id="input-return-reason-{{ return_reason.return_reason_id }}" class="form-check-input"/>
<label for="input-return-reason-{{ return_reason.return_reason_id }}" class="form-check-label">{{ return_reason.name }}</label>
</div>
{% endfor %}
</div>
<div id="error-reason" class="invalid-feedback"></div>
</div>
</div>
<div class="row mb-3 required">
<label class="col-sm-2 col-form-label">{{ entry_opened }}</label>
<div class="col-sm-10">
<div class="form-check form-check-inline">
<input type="radio" name="opened" value="1" id="input-opened-yes" class="form-check-input" checked/>
<label for="input-opened-yes" class="form-check-label">{{ text_yes }}</label>
</div>
<div class="form-check form-check-inline">
<input type="radio" name="opened" value="0" id="input-opened-no" class="form-check-input"/>
<label for="input-opened-no" class="form-check-label">{{ text_no }}</label>
</div>
</div>
</div>
<div class="row mb-3">
<label for="input-comment" class="col-sm-2 col-form-label">{{ entry_fault_detail }}</label>
<div class="col-sm-10">
<textarea name="comment" rows="5" placeholder="{{ entry_fault_detail }}" id="input-comment" class="form-control"></textarea>
</div>
</div>
{{ captcha }}
</fieldset>
<div class="d-inline-block pt-2 pd-2 w-100">
<div class="float-start"><a href="{{ back }}" class="btn btn-light">{{ button_back }}</a></div>
<div class="float-end">
{% if text_agree %}
<div class="form-check form-check-inline">
<label class="form-check-label">{{ text_agree }}</label> <input type="checkbox" name="agree" value="1" class="form-check-input"/>
</div>
{% endif %}
<button type="submit" class="btn btn-primary">{{ button_submit }}</button>
</div>
</div>
</form>
{{ content_bottom }}
</div>
{{ column_right }}
</div>
</div>
<script type="text/javascript"><!--
$(document).ready(function () {
$('.date').daterangepicker({
singleDatePicker: true,
autoApply: true,
locale: {
format: 'YYYY-MM-DD'
}
});
$('.time').daterangepicker({
singleDatePicker: true,
datePicker: false,
autoApply: true,
timePicker: true,
timePicker24Hour: true,
locale: {
format: 'HH:mm'
}
}).on('show.daterangepicker', function (ev, picker) {
picker.container.find('.calendar-table').hide();
});
$('.datetime').daterangepicker({
singleDatePicker: true,
autoApply: true,
timePicker: true,
timePicker24Hour: true,
locale: {
format: 'YYYY-MM-DD HH:mm'
}
});
});
//--></script>
{{ footer }}