@extends('member')
@section('title', 'Annual Membership - Offline')

@section('content')
    <div class="container container_rule">
		<div class="directory-sec anual-subcription">
        <ul class="breadcrumb">
            <li><a href="/home">Dashboard</a></li>
            <li>Annual Membership </li>
            <li>Payment</li>
        </ul>
    </div>
        <div class="row ">
            <div class="col-lg-8">
                <div class="Receipt-form">
                    <div class="Receipt_form">
                        <form action="{{ route('offline.subscription.submit') }}" method="POST" enctype="multipart/form-data">
                            @csrf
                            <label class="quantity-text" for="fname">Receipt Number :</label>
                            <input class="name-text" type="text" placeholder="Enter Receipt Number" name="receipt_number"
                                required>
                    </div>
                    <div class="Receipt_form">
                        <label class="quantity-text" for="fname">Receipt Date :</label>
                        <input class="name-text" type="date" placeholder="31/05/2024" name="doc_date" required>
                    </div>

                </div>
                <br>
                <div class="box-content">
                    <div class="box-text">
                        <label for="offline_receipt_document" class="quantity-text">Upload Document :</label>
                        <input type="file" class="form-control quantity-text" id="offline_receipt_document"
                            name="receipt_document" accept="image/*,application/pdf" required>
                    </div>
                </div>
            </div>
            <div class="col-lg-4">
                <div class="shiping-sec">
                    <a href="#"> <i class="fa fa-handshake-o"></i></a>
                    <h4>Membership Fees</h4>
                    <p>Year : 2023-2024</p>
                </div>
                <div class="subtotal-sec">

                    <div class="order-line">
                        <span class="sub-text">Amount</span>
                        <span class="price-text">₹ 2000.00</span>
                    </div>
                    <div class="order-line">
                        <span class="sub-text">Late Fees</span>
                        <span class="price-text">₹ 0.00</span>
                    </div>

                    <div class="order-line">
                        <span class="sub-text">Total</span>
                        <span class="price-text">₹ 2000.00</span>
                    </div>
                    <div class="order-line">
                        <button class="continue_btn " type="submit">Confirm</button>
                    </div>

                </div>
            </div>
            <input type="text" value="Annual membership" name="type" hidden>
            </form>
        </div>
    </div>
    <br>

@endsection