<form action="" name="" method="POST"> <input type="text" name="cartId" placeholder="Invoice Number"> <select name="paymentType"> <option>Payment Method</option> <option value="MSCD">Mastercard</option> <option value="DMC">Mastercard Debit</option> <option value="MAES">Maestro</option> <option value="VISA">Visa</option> <option value="VISD">Visa Debit</option> <option value="VIED">Visa Electron</option> </select> <input type="text" name="amount" placeholder="Amount"> <input type="text" name="total" value="" readonly> <input type="submit" value="Pay Now" class="wpcf7-submit"> </form>
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