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<!DOCTYPE html>
<!-- http://bootswatch.com/spacelab/ -->
<html lang="en">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
<meta charset="utf-8">
<title>Planet Express: карточка путешественника</title>
<meta name="viewport" content="width=device-width, initial-scale=1">
<!-- HTML5 shim and Respond.js IE8 support of HTML5 elements and media queries -->
<!--[if lt IE 9]>
<!--<script src="../bower_components/html5shiv/dist/html5shiv.js"></script>-->
<!--<script src="../bower_components/respond/dest/respond.min.js"></script>-->
<![endif]-->
<link href="./css/bootstrap.css" rel="stylesheet" type="text/css">
</head>
<body style="background-image: url(css/bg.png)">
<div class="navbar navbar-default navbar-fixed-top">
<div class="container">
<div class="navbar-header">
<a href="http://pxp.by/" class="navbar-brand">
Planet Express: Карточка путешественника
</a>
</div>
</div>
</div>
<div class="container">
<div class="page-header" id="banner" style="display: none">
<div class="row">
<div class="col-lg-8 col-md-7 col-sm-6">
<h1>Карточка путешественника</h1>
<p class="lead">Silvery and sleek</p>
</div>
<div class="col-lg-4 col-md-5 col-sm-6">
</div>
</div>
</div>
<!-- Forms
================================================== -->
<div class="bs-docs-section">
<div class="row">
<div class="col-lg-12">
<div class="page-header"></div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="bs-component">
<div class="panel panel-default">
<div class="panel-body form-horizontal" style="background-color: cadetblue;">
<!--<form class="form-horizontal">-->
<!--<fieldset>-->
<div class="row">
<div class="col-lg-6">
<div class="form-group">
<div class="col-lg-12">
<input type="text" class="form-control" id="inputFio" placeholder="ФИО">
</div>
</div>
<div class="form-group">
<div class="col-lg-12">
<input type="text" class="form-control" id="inputAddress" placeholder="Адрес">
</div>
</div>
<div class="form-group">
<div class="col-lg-12">
<input type="text" class="form-control" id="inputPhone" placeholder="Телефон">
</div>
</div>
<div class="form-group">
<div class="col-lg-12">
<input type="text" class="form-control" id="inputEmail" placeholder="E-mail">
</div>
</div>
</div>
<div class="col-lg-6">
<div class="form-group">
<div class="col-lg-12">
<textarea class="form-control"
style="height:197px;"
rows="6"
placeholder="Комментарий"
id="textArea"></textarea>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="panel panel-default">
<div class="panel-body form-horizontal" style="background-color: gainsboro">
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<label for="inputCount" class="col-lg-2 control-label">Количество туристов</label>
<div class="col-lg-1">
<select id="inputCount" class="form-control">
<option>1</option>
<option>2</option>
<option>3</option>
<option>4</option>
</select>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<table class="table table-striped table-hover ">
<tbody>
<tr>
<td>
<select class="form-control" style="width:77px">
<option>Mr</option>
<option>Mrs</option>
<option>Chl</option>
<option>Inf</option>
</select>
</td>
<td style="width:35%">
<input type="text" class="form-control" placeholder="Фамилия Имя"/>
</td>
<td>
<input type="text"
class="form-control"
style="width:102px;"
placeholder="МР1122333"/>
</td>
<td>
<input type="text"
class="form-control"
style="width:102px;"
placeholder="12/08/1983"/>
</td>
<td>
<input type="text"
class="form-control"
style="width:42px;"
placeholder="30"/>
</td>
<td>
<input type="text"
class="form-control"
style="width:102px;"
placeholder="12/08/2028"/>
</td>
<td style="width:35%">
<input type="text"
class="form-control"
placeholder="Контакты"/>
</td>
</tr>
<tr>
<td>
<select class="form-control" style="width:77px">
<option>Mr</option>
<option>Mrs</option>
<option>Chl</option>
<option>Inf</option>
</select>
</td>
<td style="width:35%">
<input type="text" class="form-control" placeholder="Фамилия Имя"/>
</td>
<td>
<input type="text"
class="form-control"
style="width:102px;"
placeholder="№ PASS"/>
</td>
<td>
<input type="text"
class="form-control"
style="width:102px;"
placeholder="Дата рожд."/>
</td>
<td>
<input type="text"
class="form-control"
style="width:42px;"
placeholder="30"/>
</td>
<td>
<input type="text"
class="form-control"
style="width:102px;"
placeholder="Срок PASS"/>
</td>
<td style="width:35%">
<input type="text"
class="form-control"
placeholder="Контакты"/>
</td>
</tr>
</tbody>
</table>
</div>
</div>
</div>
</div>
<div class="panel panel-default">
<div class="panel-body form-horizontal" style="background-color: yellowgreen">
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-4">
<select class="form-control">
<option>-- Услуга --</option>
</select>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-2">
<input class="form-control" type="text" placeholder="Город отправления">
</div>
<div class="col-lg-2">
<input class="form-control" type="text" placeholder="Страна">
</div>
<div class="col-lg-2">
<input class="form-control" type="text" placeholder="Регион / Курорт">
</div>
<div class="col-lg-2">
<input class="form-control" type="text" placeholder="Сроки тура с:">
</div>
<div class="col-lg-2">
<input class="form-control" type="text" placeholder="по:">
</div>
<div class="col-lg-2">
<label class="control-label">X ночей</label>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-3">
<input class="form-control" type="text" placeholder="Отель">
</div>
<div class="col-lg-1">
<select class="form-control">
<option>Звёзд</option>
<option>1</option>
<option>2</option>
<option>3</option>
<option>4</option>
<option>5</option>
</select>
</div>
<div class="col-lg-2">
<select class="form-control">
<option>Размещение</option>
</select>
</div>
<div class="col-lg-2">
<select class="form-control">
<option>Питание</option>
</select>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-6">
<input class="form-control" type="text" placeholder="Вылет">
</div>
<div class="col-lg-6">
<input class="form-control" type="text" placeholder="Обратный вылет">
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-4">
<select class="form-control">
<option>-- Оператор --</option>
</select>
</div>
<div class="col-lg-2">
<input class="form-control" type="text" placeholder="№ заявки">
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-3">
<input class="form-control" type="text" placeholder="Стоимость тура с %">
</div>
<div class="col-lg-1">
<select class="form-control">
<option>$</option>
<option>euro</option>
</select>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-3">
<input class="form-control" type="text" placeholder="Предоплата">
</div>
<div class="col-lg-1">
<select class="form-control">
<option>$</option>
<option>euro</option>
</select>
</div>
<div class="col-lg-3">19 388 500 BYR / 20.05.2014 / 13570</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-3">
<input class="form-control" type="text" placeholder="Доплата">
</div>
<div class="col-lg-1">
<select class="form-control">
<option>$</option>
<option>euro</option>
</select>
</div>
<div class="col-lg-3">19 388 500 BYR / 20.05.2014 / 13570</div>
</div>
</div>
</div>
</div>
</div>
<div class="panel panel-default">
<div class="panel-body form-horizontal" style="background-color: darkkhaki">
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-2">
<div class="checkbox">
<label>
<input type="checkbox"> Визы
</label>
</div>
</div>
<div class="col-lg-2">
<div class="checkbox">
<label>
<input type="checkbox"> Трансфер
</label>
</div>
</div>
<div class="col-lg-2">
<div class="checkbox">
<label>
<input type="checkbox"> Страховки
</label>
</div>
</div>
<div class="col-lg-2">
<div class="checkbox">
<label>
<input type="checkbox"> Подарок
</label>
</div>
</div>
<div class="col-lg-4">
<input type="text" class="form-control" placeholder="Подарок">
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="bs-component">
<ul class="nav nav-tabs" style="margin-bottom: 15px;">
<li class="active"><a href="#" data-toggle="tab">Визы</a></li>
<li><a href="#" data-toggle="tab">Трансфер</a></li>
<li><a href="#" data-toggle="tab">Страховки</a></li>
</ul>
<div id="myTabContent" class="tab-content">
<div class="tab-pane fade active in" id="visa">
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-2">
<span>MIKHAILAVA NATALIA</span>
</div>
<div class="col-lg-1">
<input type="checkbox" />
</div>
<div class="col-lg-3">
<input class="form-control" type="text" placeholder="Стоимость">
</div>
<div class="col-lg-1">
<select class="form-control">
<option>$</option>
<option>euro</option>
</select>
</div>
<div class="col-lg-2">
<select class="form-control">
<option>оплачено</option>
<option>сдано</option>
<option>вышел</option>
<option>выдано</option>
</select>
</div>
<!--<div class="col-lg-3">19 388 500 BYR / 20.05.2014 / 13570</div>-->
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-2">
<span>PETROV NIKODIM</span>
</div>
<div class="col-lg-1">
<input type="checkbox" />
</div>
<div class="col-lg-4">
65 ЕВРО / оплачено / сдано / вышел / выдано
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<textarea class="form-control" placeholder="Комментарий"></textarea>
</div>
</div>
</div>
<div class="tab-pane fade active in" id="transfer">
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-2">
<span>MIKHAILAVA NATALIA</span>
</div>
<div class="col-lg-1">
<input type="checkbox" />
</div>
<div class="col-lg-3">
<input class="form-control" type="text" placeholder="Стоимость">
</div>
<div class="col-lg-1">
<select class="form-control">
<option>$</option>
<option>euro</option>
</select>
</div>
<div class="col-lg-2">
<select class="form-control">
<option>оплачено</option>
<option>сдано</option>
<option>вышел</option>
<option>выдано</option>
</select>
</div>
<div class="col-lg-3">19 388 500 BYR / 20.05.2014 / 13570</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-2">
<span>PETROV NIKODIM</span>
</div>
<div class="col-lg-1">
<input type="checkbox" />
</div>
<div class="col-lg-6">
65 ЕВРО / оплачено / 19 388 500 BYR / 20.05.2014 / 13570
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-2">
<select class="form-control">
<option>-- Перевозчик --</option>
</select>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<textarea class="form-control" placeholder="Комментарий"></textarea>
</div>
</div>
</div>
<div class="tab-pane fade active in" id="enshurance">
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-2">
<span>MIKHAILAVA NATALIA</span>
</div>
<div class="col-lg-1">
<input type="checkbox" />
</div>
<div class="col-lg-3">
<select class="form-control">
<option>-- Страх. сумма USD --</option>
</select>
</div>
<div class="col-lg-1">
<input type="text" class="form-control" placeholder="Дн.">
</div>
<div class="col-lg-2">
<input type="text" class="form-control" placeholder="Тариф">
</div>
<div class="col-lg-2">
<select class="form-control">
<option>оплачено</option>
<option>сдано</option>
<option>вышел</option>
<option>выдано</option>
</select>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-2">
<span>PETROV NIKODIM</span>
</div>
<div class="col-lg-1">
<input type="checkbox" />
</div>
<div class="col-lg-6">
30 000 ЕВРО / 12 дн / 6 USD / оплачено
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<textarea class="form-control" placeholder="Комментарий"></textarea>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="panel panel-default">
<div class="panel-body form-horizontal" style="background-color: red">
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-3">
<input class="form-control" type="text" placeholder="Оплата оператору">
</div>
<div class="col-lg-1">
<select class="form-control">
<option>$</option>
<option>euro</option>
</select>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-3">
<div class="checkbox">
<label>
<input type="checkbox"> BYB
</label>
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</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-3">
<input class="form-control" type="text" placeholder="Предоплата">
</div>
<div class="col-lg-1">
<select class="form-control">
<option>$</option>
<option>euro</option>
</select>
</div>
<div class="col-lg-2">
<input class="form-control" type="text" placeholder="Курс">
</div>
<div class="col-lg-2">
<input class="form-control" type="text" placeholder="00/00/0000">
</div>
<div class="col-lg-3">19 388 500 BYR</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-3">
<input class="form-control" type="text" placeholder="Доплата">
</div>
<div class="col-lg-1">
<select class="form-control">
<option>$</option>
<option>euro</option>
</select>
</div>
<div class="col-lg-2">
<input class="form-control" type="text" placeholder="Курс">
</div>
<div class="col-lg-2">
<input class="form-control" type="text" placeholder="00/00/0000">
</div>
<div class="col-lg-3">19 388 500 BYR</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-3">
<input class="form-control" type="text" placeholder="Комиссия">
</div>
<div class="col-lg-1">
<select class="form-control">
<option>$</option>
<option>euro</option>
</select>
</div>
<div class="col-lg-3">
<input class="form-control" type="text" placeholder="Комиссия BYB">
</div>
<div class="col-lg-1">
7.8%
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-3">
<input class="form-control" type="text" placeholder="Комиссия менеджеру">
</div>
<div class="col-lg-1">
<select class="form-control">
<option>$</option>
<option>euro</option>
</select>
</div>
<div class="col-lg-3">
<div class="checkbox">
<label>
<input type="checkbox"> Выплачено
</label>
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-3">
<input class="form-control" type="text" placeholder="Доп.комиссия менеджеру">
</div>
<div class="col-lg-1">
<select class="form-control">
<option>$</option>
<option>euro</option>
</select>
</div>
<div class="col-lg-8">
<input class="form-control" type="text" placeholder="Комментарий">
</div>
</div>
</div>
</div>
<div class="row">
<div> </div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-3">
<input class="form-control" type="text" placeholder="Комиссия">
</div>
<div class="col-lg-1">
<select class="form-control">
<option>$</option>
<option>euro</option>
</select>
</div>
<div class="col-lg-3">
<input class="form-control" type="text" placeholder="Комиссия BYB">
</div>
<div class="col-lg-1">
5.3%
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<div class="col-lg-12">
<textarea class="form-control" placeholder="Комментарий"></textarea>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
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