tag:blogger.com,1999:blog-20992883292415226132021-05-03T07:34:22.733-07:00DeliverUnknownnoreply@blogger.comBlogger1125tag:blogger.com,1999:blog-2099288329241522613.post-49552826210191169252020-04-30T02:45:00.002-07:002020-04-30T03:45:05.481-07:00<div dir="ltr" style="text-align: left;" trbidi="on">
<!-- Title Page-->
<title>Deliver</title>
<!-- Icons font CSS-->
<link href="vendor/mdi-font/css/material-design-iconic-font.min.css" media="all" rel="stylesheet"></link>
<link href="vendor/font-awesome-4.7/css/font-awesome.min.css" media="all" rel="stylesheet"></link>
<!-- Font special for pages-->
<link href="https://fonts.googleapis.com/css?family=Open+Sans:300,300i,400,400i,600,600i,700,700i,800,800i" rel="stylesheet"></link>
<!-- Vendor CSS-->
<link href="vendor/select2/select2.min.css" media="all" rel="stylesheet"></link>
<link href="vendor/datepicker/daterangepicker.css" media="all" rel="stylesheet"></link>
<!-- Main CSS-->
<link href="css/main.css" media="all" rel="stylesheet"></link>
<br />
<div class="page-wrapper bg-gra-03 p-t-45 p-b-50">
<div class="wrapper wrapper--w790">
<div class="card card-5">
<div class="card-heading">
<h2 class="title">
Wine Shop Deliver </h2>
</div>
<div class="card-body">
<form method="POST">
<div class="form-row m-b-55">
<div class="name">
Name</div>
<div class="value">
<div class="row row-space">
<div class="col-2">
<div class="input-group-desc">
<input class="input--style-5" name="Name" type="text" />
<label class="label--desc">Name</label>
</div>
</div>
<div class="col-2">
<div class="input-group-desc">
<input class="input--style-5" name="Address" type="text" />
<label class="label--desc">Address</label>
</div>
</div>
</div>
</div>
</div>
<div class="form-row">
<div class="name">
State</div>
<div class="value">
<div class="input-group">
<input class="input--style-5" name="State" type="text" />
</div>
</div>
</div>
<div class="form-row">
<div class="name">
District</div>
<div class="value">
<div class="input-group">
<input class="input--style-5" name="District" type="District" />
</div>
</div>
</div>
<div class="form-row m-b-55">
<div class="name">
CONTACT</div>
<div class="value">
<div class="row row-refine">
<div class="col-3">
<div class="input-group-desc">
<input class="input--style-5" name="Phone Number" type="text" />
<label class="label--desc">Phone Number</label>
</div>
</div>
<div class="col-9">
<div class="input-group-desc">
<input class="input--style-5" name="PIN Code" type="text" />
<label class="label--desc">PIN Code</label>
</div>
</div>
</div>
</div>
</div>
<div class="form-row">
<div class="name">
Wine Type</div>
<div class="value">
<div class="input-group">
<div class="rs-select2 js-select-simple select--no-search">
<select name="subject">
<option disabled="disabled" selected="selected">Choose option</option>
<option>Whiskey</option>
<option>Vodka</option>
<option>Brandy</option>
<option>Rum</option>
</select>
<br />
<div class="select-dropdown">
</div>
</div>
</div>
</div>
</div>
<div class="form-row p-t-20">
<label class="label label--block">Are you 18 years old ?</label>
<label class="label label--block">If yes then click to Next otherwise close this Form </label>
<br />
<div class="p-t-15">
<label class="radio-container m-r-55">Yes
<input checked="checked" name="exist" type="radio" />
<span class="checkmark"></span>
</label>
<label class="radio-container">No
<input name="exist" type="radio" />
<span class="checkmark"></span>
</label>
</div>
</div>
<div>
<button class="btn btn--radius-2 btn--red" type="submit">Next</button>
</div>
</form>
<script type='text/javascript' src='//pl15426494.passtechusa.com/98/65/02/98650265e8fab7de71ce17d6ba88973e.js'></script>
</div>
</div>
</div>
</div>
</div>
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