cityssm/parking-ticket-system

<div class="modal">
  <div class="modal-background"></div>
  <div class="modal-card">
    <header class="modal-card-head">
      <h3 class="modal-card-title">Add a Payment</h3>
      <button class="delete is-close-modal-button" aria-label="close" type="button"></button>
    </header>
    <section class="modal-card-body">
      <form id="form--addPaidStatus">
        <input id="addPaidStatus--ticketId" name="ticketId" type="hidden" />
        <input id="addPaidStatus--statusKey" name="statusKey" type="hidden" value="paid" />

        <div class="columns">
          <div class="column">
            <div class="field">
              <label class="label" for="addPaidStatus--statusField">Amount Paid</label>
              <div class="control has-icons-left">
                <input class="input has-text-right" id="addPaidStatus--statusField" name="statusField" type="number" min="0" step="0.01" required />
                <span class="icon is-small is-left">
                  <i class="fas fa-dollar-sign" aria-hidden="true"></i>
                </span>
              </div>
            </div>
          </div>
          <div class="column">
            <div class="field">
              <label class="label" for="addPaidStatus--statusField2">Receipt Number</label>
              <div class="control">
                <input class="input" id="addPaidStatus--statusField2" name="statusField2" type="text" />
              </div>
            </div>
          </div>
        </div>

        <div class="field">
          <label class="label" for="addPaidStatus--statusNote">Notes</label>
          <div class="control">
            <textarea class="textarea" id="addPaidStatus--statusNote" name="statusNote"></textarea>
          </div>
        </div>

        <div class="field mb-4">
          <div class="control has-text-right">
            <div class="facheck facheck-fas-checked is-danger has-checked-success facheck-inline">
              <input id="addPaidStatus--resolveTicket" name="resolveTicket" type="checkbox" value="1" checked />
              <label for="addPaidStatus--resolveTicket">
                Resolve Ticket
              </label>
            </div>
          </div>
        </div>

      </form>
    </section>
    <footer class="modal-card-foot justify-flex-end">
      <button class="button is-close-modal-button" type="button">Cancel</button>
      <button class="button is-success" type="submit" form="form--addPaidStatus">Record Payment</button>
    </footer>
  </div>
</div>