<form method="post">
	<br />
	<div class="backgroundWhiteBorder">
		<div class="container">
			<div class="card">
				<div class="card-header bg-dark text-light ml-0 ">
					<div class="row">
						<div class="col-6 pt-2">
							<h3 class="text-white-50">Order Summary</h3>
						</div>
						<div class="col-6 text-end">
							<a class="btn btn-outline-info btn-sm">Back to Cart</a>
						</div>
					</div>
				</div>
				<div class="card-body">
					<div class="container rounded p-2">
						<div class="row">
							<div class="col-12 col-lg-6 pb-4">
								<div class="row">
									<h4 class="d-flex justify-content-between align-items-center mb-3">
										<span class="text-info">PickUp Details:</span>
									</h4>
								</div>
								<div class="row my-1">
									<div class="col-3">
										<label>Name</label>
									</div>
									<div class="col-9">
										<input class="form-control" />
									</div>
								</div>
								<div class="row my-1">
									<div class="col-3">
										<label>Phone Number</label>
									</div>
									<div class="col-9">
										<input class="form-control" />
									</div>
								</div>
								<div class="row my-1">
									<div class="col-3">
										<label>Pickup Date</label>
									</div>
									<div class="col-9">
										<input type="date" class="form-control" />
									</div>
								</div>
								<div class="row my-1">
									<div class="col-3">
										<label>Pickup Time</label>
									</div>
									<div class="col-9">
										<input type="time" class="form-control" />
									</div>
								</div>
								<div class="row my-1">
									<div class="col-3">
										<label>Additional Instructions: </label>
									</div>
									<div class="col-9">
										<textarea style="height:100px;" class="form-control"></textarea>
									</div>
								</div>
							</div>

							<div class="col-12 col-lg-5 offset-lg-1">
								<h4 class="d-flex justify-content-between align-items-center mb-3">
									<span class="text-info">Order Summary:</span>
								</h4>
								<ul class="list-group mb-3">
									<li class="list-group-item d-flex justify-content-between">
										<div>
											<h6 class="my-0">Name</h6>
											<small class="text-muted">Quantity: Count</small>
										</div>
										<span class="text-muted">$Price * Count</span>
									</li>
									<li class="list-group-item d-flex justify-content-between bg-light">
										<small class="text-info">Total (USD)</small>
										<strong class="text-info">$</strong>
									</li>
								</ul>
							</div>
						</div>
					</div>
				</div>
				<div class="card-footer">
					<div class="row">
						<div class="col-12 col-md-4 offset-md-8">
							<button type="submit" id="btnPlaceOrder" value="Place Order" class="btn btn-success form-control">Place Order</button>
						</div>
					</div>
				</div>
			</div>
		</div>
	</div>
</form>