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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="2050261"/></td> </tr> <tr> <td>Order Id :</td><td><input type="text" name="order_id" value="12376654789"/></td> </tr> <tr> <td>Amount :</td><td><input type="text" name="amount" value="100.00"/></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="https://adjointinfocom.com/php/ccavResponseHandler.php"/></td> </tr> <tr> <td>Cancel URL :</td><td><input type="text" name="cancel_url" value="https://adjointinfocom.com/php/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>