{{ Form::hidden('financialInstitutionsUrl', action('PaymentController@postFinancialinstitutionsoptions', array()), array('id'=>'financialInstitutionsUrl')) }}
<div class="row">
    <div class="col-md-6">
        <div class="form-horizontal">
            <div class="form-group">
                {{ Form::label('guardian', 'Quien realiza el pago:', array('class' => 'col-md-6 control-label')) }}
                <div class="col-md-6">
                    {{ Form::select('guardian', $guardians, $paymentDetail->serial_grd, array('class' => 'form-control', 'id' => 'guardian')) }}
                </div>
            </div>
            <div class="form-group">
                {{ Form::label('kinship_pdt', 'Relaci&oacute;n con el estudiante:', array('class' => 'col-md-6 control-label')) }}
                <div class="col-md-6">
                    {{ Form::select('kinship_pdt', $relationships, $paymentDetail->kinship_pdt, array('class' => 'form-control', 'id' => 'kinship_pdt')) }}
                </div>
            </div>
            <div class="form-group">
                {{ Form::label('id_owner_pdt', 'C&eacute;dula:', array('class' => 'col-md-6 control-label')) }}
                <div class="col-md-6">
                    {{ Form::text('id_owner_pdt', $paymentDetail->id_owner_pdt, array('class' => 'form-control', 'id' => 'id_owner_pdt')) }}
                </div>
            </div>
            <div class="form-group">
                {{ Form::label('cellphone_owner_pdt', 'Celular:', array('class' => 'col-md-6 control-label')) }}
                <div class="col-md-6">
                    {{ Form::text('cellphone_owner_pdt', $paymentDetail->cellphone_owner_pdt, array('class' => 'form-control', 'id' => 'cellphone_owner_pdt')) }}
                </div>
            </div>
            <div class="form-group">
                {{ Form::label('phone_owner_pdt', 'Tel&eacute;fono casa:', array('class' => 'col-md-6 control-label')) }}
                <div class="col-md-6">
                    {{ Form::text('phone_owner_pdt', $paymentDetail->phone_owner_pdt, array('class' => 'form-control', 'id' => 'phone_owner_pdt')) }}
                </div>
            </div>
        </div>
    </div>
    <div class="col-md-6">
        <div class="form-horizontal">
            <div class="form-group">
                {{ Form::label('serial_ccd', 'Tarjeta:', array('class' => 'col-md-6 control-label')) }}
                <div class="col-md-6">
                    {{ Form::select('serial_ccd', $cards, $paymentDetail->serial_ccd, array('class' => 'form-control', 'id' => 'serial_ccd')) }}
                </div>
            </div>
            <div class="form-group">
                {{ Form::label('serial_fin', 'Banco/Emisor:', array('class' => 'col-md-6 control-label')) }}
                <div class="col-md-6">
                    {{Form::hidden('hdnPymentDetailFamilySerialFin',$paymentDetail->serial_fin,array('id'=>'hdnPymentDetailFamilySerialFin'))}}
                    {{ Form::select('serial_fin', array('' => 'Seleccione'), '', array('class' => 'form-control', 'id' => 'serial_fin')) }}
                </div>
            </div>
            <div class="form-group">
                {{ Form::label('document_number_pdt', 'Nº de tarjeta:', array('class' => 'col-md-6 control-label')) }}
                <div class="col-md-6">
                    {{ Form::text('document_number_pdt', $paymentDetail->document_number_pdt, array('class' => 'form-control', 'id' => 'document_number_pdt')) }}
                </div>
            </div>
            <div class="form-group">
                <div class="row">
                    {{ Form::label('date_expire_year', 'Fecha de Exp. (mes/año):', array('class' => 'col-md-6 control-label')) }}
                    <div class="col-md-2">
                        {{ Form::text('date_expire_month', $paymentDetail->date_month_expire_pdt, array('class' => 'form-control', 'id' => 'date_expire_month','placeholder'=>'mm')) }}
                    </div>
                    <div class="col-md-2">
                        {{ Form::text('date_expire_year', $paymentDetail->date_year_expire_pdt, array('class' => 'form-control', 'id' => 'date_expire_year','placeholder'=>'aa')) }}
                    </div>
                </div>
            </div>
            <div class="form-group">
                {{ Form::label('owner_pdt', 'Nombre due&ntilde;o de la tarjeta habiente:', array('class' => 'col-md-6 control-label')) }}
                <div class="col-md-6">
                    {{ Form::text('owner_pdt', $paymentDetail->owner_pdt, array('class' => 'form-control', 'id' => 'owner_pdt')) }}
                </div>
            </div>
        </div>
    </div>
</div>
<div class="row" id="amountOfFeesgg">
</div>

{{ HTML::script('js/payment/card.js') }}