{{ header }}
<header class="background-white bottom-margin-large">
  <div class="container-fluid">
    <div class="row no-space-xs">
      <div class="col-xs-12">
        <div class="content-box vertical-padding-large flex between-xs middle-xs">
          <div>
            <span class="text-x-large text-dark">{{ heading_title }}</span>
            <div class="adm-breadcrumb">
              {% for breadcrumb in breadcrumbs %}
                <i class="fas fa-angle-right text-x-small text-gray horizontal-padding-small"></i>
                <a href="{{ breadcrumb.href }}" class="text-x-small text-gray text-decoration-none">{{ breadcrumb.text }}</a>
              {% endfor %}
            </div>
          </div>
          <div class="flex flex-row middle-xs">
            <a href="{{ cancel }}" class="right-margin-small btn-default btn-medium btn-outline">
              <span>{{ button_cancel }}</span>
            </a>
            <button class="btn-default btn-medium btn-primary js-submit-main-form">
              <span>{{ button_save }}</span>
            </button>
          </div>
          {% if error_warning %}
            <div class="warning full-width">{{ error_warning }}</div>
          {% endif %}
        </div>
      </div>
    </div>
  </div>
</header>
<div class="container-fluid">
  <form action="{{ action }}" method="post" class="js-main-form">
    <div class="row">
      <div class="col-xs-12 col-md-8">
        <div class="background-white padding-large bottom-margin-medium shadow-small">
          <label class="field field-medium bottom-margin-large">
            <span class="field-label">{{ entry_title }}</span>
            <input class="field-entry" type="text" name="bank_transfer_title" value="{{ bank_transfer_title }}"/>
          </label>
          <label class="field field-medium bottom-margin-large">
            <span class="field-label">{{ entry_total }}</span>
            <span class="text-x-small text-gray">{{ entry_total_obs }}</span>
            <input class="field-entry mask-money" type="text" name="bank_transfer_total" class="numeric" value="{{ bank_transfer_total }}" />
          </label>
          <label class="field field-medium bottom-margin-large">
            <span class="field-label">{{ entry_days }}</span>
            <span class="text-x-small text-gray">{{ entry_days_obs }}</span>
            <input class="field-entry mask-number" type="text" name="bank_transfer_cont_valid_days" class="numeric" maxlength="3" value="{{ bank_transfer_cont_valid_days }}" />
          </label>
          {% for language in languages %}
            <label class="field field-medium bottom-margin-large">
              <span class=" field-label required">{{ entry_bank }}</span>
              <textarea class="field-entry" name="{{ 'bank_transfer_bank_' ~ language.language_id }}" rows="4" maxlength="250">{{ (bank_transfer_bank) is defined ? bank_transfer_bank : '' }}</textarea>
              {% if error_bank is defined %}
                <span class="error">{{ error_bank }}</span>
              {% endif %}
            </label>
          {% endfor %}
          <label class="field field-medium bottom-margin-large">
            <span class="field-label">{{ entry_order_status }}</span>
            <select class="field-entry" name="bank_transfer_order_status_id">
              {% for order_status in order_statuses %}
                <option value="{{ order_status.order_status_id }}" {{ (order_status.order_status_id == bank_transfer_order_status_id) ? 'selected="selected"' : '' }}>
                  {{ order_status.name }}
                </option>
              {% endfor %}
            </select>
          </label>
          <label class="field field-medium bottom-margin-large">
            <span class="field-label">{{ entry_order_status_pago }}</span>
            <select class="field-entry" name="bank_transfer_order_status_pago_id">
              {% for order_status in order_statuses %}
                <option value="{{ order_status.order_status_id }}" {{ (order_status.order_status_id == bank_transfer_order_status_pago_id) ? 'selected="selected"' : '' }}>
                  {{ order_status.name }}
                </option>
              {% endfor %}
            </select>
          </label>
          <label class="field field-medium">
            <span class="field-label">{{ entry_order_system }}</span>
            <select class="field-entry" name="bank_transfer_order_status_system_id">
              {% for order_status in order_statuses %}
                <option value="{{ order_status.order_status_id }}" {{ (order_status.order_status_id == bank_transfer_order_status_system_id) ? 'selected="selected"' : '' }}>
                  {{ order_status.name }}
                </option>
              {% endfor %}
            </select>
          </label>
        </div>
      </div>
      <div class="col-xs-12 col-md-4">
        <div class="background-white padding-large bottom-margin-medium shadow-small">
          <label class="field field-medium bottom-margin-large">
            <span class="field-label">{{ entry_status }}</span>
            <select class="field-entry" name="bank_transfer_status">
              <option value="1" {{ bank_transfer_status ? 'selected="selected"' : '' }}>{{ text_enabled }}</option>
              <option value="0" {{ bank_transfer_status ? '' : 'selected="selected"' }}>{{ text_disabled }}</option>
            </select>
          </label>
          <label class="field field-medium bottom-margin-large">
            <span class="field-label">{{ entry_display }}</span>
            <select class="field-entry" name="bank_transfer_display" >
              {% for display in display_modules %}
                <option value="{{ display.key }}" {{ display.selected }}>{{ display.value }}</option>
              {% endfor %}
            </select>
          </label>
          <label class="field field-medium bottom-margin-large">
            <span class="field-label">{{ entry_sort_order }}</span>
            <input class="field-entry mask-number" type="text" name="bank_transfer_sort_order" class="numeric" value="{{ bank_transfer_sort_order }}" size="1" />
          </label>
          <label class="field field-medium">
            <span class="field-label">{{ entry_geo_zone }}</span>
            <select class="field-entry" name="bank_transfer_geo_zone_id">
              <option value="0">{{ text_all_zones }}</option>
              {% for geo_zone in geo_zones %}
                <option value="{{ geo_zone.geo_zone_id }}" {{ (geo_zone.geo_zone_id == bank_transfer_geo_zone_id) ? 'selected="selected"' : '' }}>
                  {{ geo_zone.name }}
                </option>
              {% endfor %}
            </select>
          </label>
        </div>
      </div>
    </div>
  </form>
</div>