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<html>
<head>
<script>
window.onload = function() {
var d = new Date().getTime();
document.getElementById("tid").value = d;
};
</script>
</head>
<body>
<form method="post" name="customerData" action="ccavRequestHandler.php">
<table width="40%" height="100" border='1' align="center"><caption><font size="4" color="blue"><b>Integration Kit</b></font></caption></table>
<table width="40%" height="100" border='1' align="center">
<tr>
<td>Parameter Name:</td><td>Parameter Value:</td>
</tr>
<tr>
<td colspan="2"> Compulsory information</td>
</tr>
<tr>
<td>TID :</td><td><input type="text" name="tid" id="tid" readonly /></td>
</tr>
<tr>
<td>Merchant Id :</td><td><input type="text" name="merchant_id" value="2903762"/></td>
</tr>
<tr>
<td>Order Id :</td><td><input type="text" name="order_id" value="123654789"/></td>
</tr>
<tr>
<td>Amount :</td><td><input type="text" name="amount" value="1.00"/></td>
</tr>
<tr>
<td>Currency :</td><td><input type="text" name="currency" value="INR"/></td>
</tr>
<tr>
<td>Redirect URL :</td><td><input type="text" name="redirect_url" value="http://localhost/Non_Seamless_kit/ccavResponseHandler.php"/></td>
</tr>
<tr>
<td>Cancel URL :</td><td><input type="text" name="cancel_url" value="http://localhost/Non_Seamless_kit/ccavResponseHandler.php"/></td>
</tr>
<tr>
<td>Language :</td><td><input type="text" name="language" value="EN"/></td>
</tr>
<tr>
<td colspan="2">Billing information(optional):</td>
</tr>
<tr>
<td>Billing Name :</td><td><input type="text" name="billing_name" value="Charli"/></td>
</tr>
<tr>
<td>Billing Address :</td><td><input type="text" name="billing_address" value="Room no 1101, near Railway station Ambad"/></td>
</tr>
<tr>
<td>Billing City :</td><td><input type="text" name="billing_city" value="Indore"/></td>
</tr>
<tr>
<td>Billing State :</td><td><input type="text" name="billing_state" value="MP"/></td>
</tr>
<tr>
<td>Billing Zip :</td><td><input type="text" name="billing_zip" value="425001"/></td>
</tr>
<tr>
<td>Billing Country :</td><td><input type="text" name="billing_country" value="India"/></td>
</tr>
<tr>
<td>Billing Tel :</td><td><input type="text" name="billing_tel" value="9876543210"/></td>
</tr>
<tr>
<td>Billing Email :</td><td><input type="text" name="billing_email" value="test@test.com"/></td>
</tr>
<tr>
<td colspan="2">Shipping information(optional)</td>
</tr>
<tr>
<td>Shipping Name :</td><td><input type="text" name="delivery_name" value="Chaplin"/></td>
</tr>
<tr>
<td>Shipping Address :</td><td><input type="text" name="delivery_address" value="room no.701 near bus stand"/></td>
</tr>
<tr>
<td>shipping City :</td><td><input type="text" name="delivery_city" value="Hyderabad"/></td>
</tr>
<tr>
<td>shipping State :</td><td><input type="text" name="delivery_state" value="Andhra"/></td>
</tr>
<tr>
<td>shipping Zip :</td><td><input type="text" name="delivery_zip" value="425001"/></td>
</tr>
<tr>
<td>shipping Country :</td><td><input type="text" name="delivery_country" value="India"/></td>
</tr>
<tr>
<td>Shipping Tel :</td><td><input type="text" name="delivery_tel" value="9876543210"/></td>
</tr>
<tr>
<td>Merchant Param1 :</td><td><input type="text" name="merchant_param1" value="additional Info."/></td>
</tr>
<tr>
<td>Merchant Param2 :</td><td><input type="text" name="merchant_param2" value="additional Info."/></td>
</tr>
<tr>
<td>Merchant Param3 :</td><td><input type="text" name="merchant_param3" value="additional Info."/></td>
</tr>
<tr>
<td>Merchant Param4 :</td><td><input type="text" name="merchant_param4" value="additional Info."/></td>
</tr>
<tr>
<td>Merchant Param5 :</td><td><input type="text" name="merchant_param5" value="additional Info."/></td>
</tr>
<tr>
<td>Promo Code :</td><td><input type="text" name="promo_code" value=""/></td>
</tr>
<tr>
<td>Vault Info. :</td><td><input type="text" name="customer_identifier" value=""/></td>
</tr>
<tr>
<td></td><td><INPUT TYPE="submit" value="CheckOut"></td>
</tr>
</table>
</form>
</body>
</html>