<div class="modal fade" id="invoice_create_shipping" data-keyboard="false" data-backdrop="static">
     
    <div class="modal-dialog" id="invoicestracking">
          
        <div class="modal-content">
              
            <div class="modal-header">
                 
                <button type="button" class="close" id="close_trackinvoice" data-dismiss="modal" aria-label="Close">
                    <span aria-hidden="true">&times;</span>
                </button>
                <h4 class="modal-title">Pickup Registraion </h4>
            </div>
            <div class="modal-body">
            
                <div class="box box-primary">
            
                    <div class="box-body">

						<div id="bluedart_shipment_creation">
						<form name="pickupregistraion" id="bluedart_shipment" novalidate="novalidate">
							  <FIELDSET class="bluedart_shipment_creation_fieldset">
							  <legend>Demographic Details</legend>
							  <label>Area <span class="required">*</span></label><input type="text" class="required textwidtharea" id="shipper_area" name="shipper_area" value="" maxlength="3"/>
							  <label>Customer code <span class="required">*</span></label><input type="text" class="required" id="shipper_customercode" name="shipper_customercode" value="" maxlength="6" />
							</FIELDSET>
							<FIELDSET class="bluedart_shipment_creation_fieldset">
							  <legend>Client Details</legend>
							  <div class="inner_div">
							  <label>Client Name <span class="required">*</span></label><input type="text" class="required textwidth" id="shipper_clientname" name="shipper_clientname" value="" maxlength="30" />
							  
							  <label>ChkToPay</label>
							  <label class="combine"><!--<input class="radio" type="checkbox" name="isToPayShipper">-->
							  <input class="radio" type="checkbox" id="isToPayShipper" name="isToPayShipper" value="1" data-unchecked="0" />
							  
							  </label>
							  </div>
							  <label style="clear:both">Address</label>
							  <input class="textwidth" type="text" id="shipper_address1" name="shipper_address1" value="" maxlength="30"/>
							  <input class="textwidth" type="text" id="shipper_address2" name="shipper_address2" value="" maxlength="30"/>
							  <input class="textwidth" type="text" id="shipper_address3" name="shipper_address3" value="" maxlength="30"/>
							  <label style="clear:both">Pincode <span class="required">*</span></label>
							  <input maxlength="6" type="text" class="required" id="shipper_pincode" name="shipper_pincode" value=""/>
							  <label style="clear:both">Mobile</label>
							  <input maxlength="15" type="text" id="shipper_mobile" name="shipper_mobile" value=""/>
							  <label></label>
							  <label>Telephone</label>
							  <input type="text" maxlength="15" id="shipper_telephone" name="shipper_telephone" value=""/>
							  <label style="clear:both">Contact Person</label>
							  <input class="textwidth" type="text" id="shipper_contactperson" name="shipper_contactperson" value="" maxlength="30"/>
							  <label>Email</label>
							  <input class="textwidth" type="text" id="shipper_email" name="shipper_email" value="" maxlength="30"/>
							  <label style="clear:both">Pickup Date <span class="required">*</span></label>
							  <input type="text" class="required" id="service_pickupdate" name="service_pickupdate" value=""/>
							  <label style="clear:both">Pickup Ready Time <span class="required">*</span></label><input type="text" class="required textwidtharea" id="service_pickupreadytime" name="service_pickupreadytime" value="" maxlength="5"/><span>&nbsp;&nbsp;(Format 23:59)&nbsp;&nbsp;</span>
							  <label>Office Close Time <span class="required">*</span></label><input type="text" class="required textwidtharea" id="OfficeCloseTime" name="OfficeCloseTime" value="" maxlength="5"/><span>&nbsp;&nbsp;(Format 23:59)</span>
							</FIELDSET>
							<FIELDSET class="bluedart_shipment_creation_fieldset">
							  <legend>Product Details</legend>
								<label>Pieces</label><input type="text" class="textwidtharea" id="service_pieces" name="service_pieces" value="" maxlength="4"/>
							  <label>Product Code <span class="required">*</span></label>
							  <input onchange="onchangeproductcode(this.value);" maxlength="1" type="text" class="required" id="service_productcode" name="service_productcode" value=""/>
							  <label style="clear:both">Actual.wt</label><input type="text" id="service_actweight" name="service_actweight" value="" maxlength="11"/>
							  <label>vol.wt</label>
							  <input style="width:50px;float:left;" type="text" id="volume_weight" name="volume_weight" value="" maxlength="11"/>
							  <label style="margin-top:10px;clear:both">Is Sub Products</label>    
								<div class="checkbox" id="subproduccheckbox">
								<?php $ProductCode = 'A'; ?>

								<?php 
								if($ProductCode == 'A' || !$ProductCode){ ?>
								  <input class="radio" type="checkbox" name="chktopay" value="TDD"><span>TDD</span>
								  <input class="radio" type="checkbox" name="chktopay" value="DOD"><span>DOD</span>
								  <input class="radio" type="checkbox" name="chktopay" value="etailing"><span>E-Tailing</span>
								  <input class="radio" type="checkbox" name="chktopay" value="exp100"><span>Exppress pallete 100</span>
								  <input class="radio" type="checkbox" name="chktopay" value="exp75"><span>Exppress pallete 75</span>
								  <input class="radio" type="checkbox" name="chktopay" value="exp50"><span>Exppress pallete 50</span>
								  <input class="radio" type="checkbox" name="chktopay" value="smartmulti"><span>Smart Box Multi</span>
								  <input style="clear:both"  class="radio" type="checkbox" name="chktopay" value="smart25"><span>Smart Box 25</span>
								  <input class="radio" type="checkbox" name="chktopay" value="smart10"><span>Smart Box 10</span>
								  <input class="radio" type="checkbox" name="chktopay" value="edl"><span>EDL</span>
								  <input class="radio" type="checkbox" name="chktopay" value="dc"><span>DC</span>
								  <input class="radio" type="checkbox" name="chktopay" value="fov"><span>FOV</span>
								  <input class="radio" type="checkbox" name="chktopay" value="fod"><span>FOD</span>
								 <?php } else
								 if($ProductCode == 'D'){ ?>
								  <input class="radio" type="checkbox" name="chktopay" value="TDD"><span>TDD</span>
								  <input class="radio" type="checkbox" name="chktopay" value="criticalexp"><span>Critical Express</span>
								 <?php } else
								 if($ProductCode == 'E'){ ?>
								  <input class="radio" type="checkbox" name="chktopay" value="DOD"><span>DOD</span>
								  <input class="radio" type="checkbox" name="chktopay" value="exp100"><span>Exppress pallete 100</span>
								  <input class="radio" type="checkbox" name="chktopay" value="exp75"><span>Exppress pallete 75</span>
								  <input class="radio" type="checkbox" name="chktopay" value="exp50"><span>Exppress pallete 50</span>
								  <input class="radio" type="checkbox" name="chktopay" value="smartmulti"><span>Smart Box Multi</span>
								  <input style="clear:both"  class="radio" type="checkbox" name="chktopay" value="smart25"><span>Smart Box 25</span>
								  <input class="radio" type="checkbox" name="chktopay" value="smart10"><span>Smart Box 10</span>
								  <input class="radio" type="checkbox" name="chktopay" value="edl"><span>EDL</span>
								  <input class="radio" type="checkbox" name="chktopay" value="dc"><span>DC</span>
								  <input class="radio" type="checkbox" name="chktopay" value="fov"><span>FOV</span>
								  <input class="radio" type="checkbox" name="chktopay" value="fod"><span>FOD</span>
								 <?php } else
								 if($ProductCode == 'I'){ ?>
								  <input class="radio" type="checkbox" name="chktopay" value="DTP"><span>DTP</span>
								  <input class="radio" type="checkbox" name="chktopay" value="expeasy6"><span>Express Easy 6</span>
								  <input class="radio" type="checkbox" name="chktopay" value="expeasy8"><span>Express Easy 8</span>
								  <input class="radio" type="checkbox" name="chktopay" value="exppallete"><span>Exppress pallete</span>
								  <input class="radio" type="checkbox" name="chktopay" value="impexp"><span>Imp/EXP</span>
								  <input class="radio" type="checkbox" name="chktopay" value="sii"><span>SII</span>
								 <?php } else { ?>

								 <?php } ?>
								</div>
							  
							  <label>Product Type</label>
							  
								<input class="radio radio1" type="radio" name="DoxNDox" id="DoxNDox" value="1" checked="checked"><span>Dox</span>
								<input class="radio radio1" type="radio" name="DoxNDox" id="DoxNDox" value="2" ><span>nDox</span>
							  
							  <br/><br/>
							  
							  <label>PURouteCode</label><input type="text" class="textwidtharea" id="route_code" name="route_code" value="99" maxlength="2"/>
							</FIELDSET>
							<FIELDSET class="bluedart_shipment_creation_fieldset" style="clear:both">
							  <legend>Remarks</legend>
							  <label>Remarks</label><input type="text" name="remarks" id="remarks" maxlength="60"/>
							  <label>Ref No</label><input type="text" value=""name="refno" id="refno"/>
							</FIELDSET>
							<button type="submit" class="go_button">Register Pickup</button>
							<button class="go_button" type="button" onclick="reset()">Reset</button>

						<div id = "waybillvalidmessage" class = "waybillvalidmessage">
						<div id="ajax-loader" style="display:none">
						  <img src="">
						</div>
						</form>
						</div>
					</div>
					
				    </div>
				</div>
			</div>
		</div>
	</div>
</div>