{"id":375,"date":"2022-10-12T13:32:19","date_gmt":"2022-10-12T12:32:19","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/onlinepayments\/?page_id=375"},"modified":"2026-08-26T09:23:20","modified_gmt":"2026-08-26T08:23:20","slug":"other","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/onlinepayments\/other\/","title":{"rendered":"Other"},"content":{"rendered":"\n<style data-wp-block-html=\"css\">\r\n#container {\r\n        display: grid;\r\n        width: 600px;\r\n        border: 1px solid black;\r\n        padding: 10px;\r\n        padding-left: 20px;\r\n        grid-template-columns: auto auto auto;\r\n        border-radius: 5px;\r\n        justify-items: stretch;\r\n        justify-content: space-around;\r\n    }\r\n\r\n    .header {\r\n        grid-column: 1 \/ span 3;\r\n        text-align: center;\r\n        font-weight: bold;\r\n        font-size: larger;\r\n    }\r\n\r\n    \/* .user-info-container {\r\n    grid-column: 1 \/ span 1;\r\n} *\/\r\n\r\n    .address-container {\r\n        grid-column: 1 \/ span 1;\r\n    }\r\n\r\n    .payment-container {\r\n        grid-column: 2 \/ span 1;\r\n    }\r\n\r\n    .label {\r\n        font-size: 13px !important;\r\n        margin-top: 10px;\r\n        text-align: left;\r\n        font-weight: bold;\r\n        margin-bottom: 5px;\r\n    }\r\n\r\n    .footer {\r\n        grid-column: 1 \/ span 3;\r\n        text-align: center;\r\n        border-top: 1px solid black;\r\n        padding: 5px;\r\n        margin-top: 20px;\r\n        padding-top: 15px;\r\n        display: flex;\r\n        justify-content: space-between;\r\n        background-color: transparent;\r\n    }\r\n\r\n    input[type=\"text\"] {\r\n        width: 200px;\r\n        font-size: small !important;\r\n        height: 30px;\r\n    }\r\n    \r\n    textarea {\r\n        width: 200px;\r\n        font-size: small !important;\r\n    }\r\n\r\n    .input-field:hover,\r\n    select:hover, textarea:hover {\r\n        border: 2px solid;\r\n    }\r\n\r\n    select {\r\n        width: 210px;\r\n        padding: 3px;\r\n        cursor: pointer;\r\n        font-size: small !important;\r\n        height: 30px;\r\n    }\r\n\r\n    input[type=\"submit\"],\r\n    input[type=\"button\"],\r\n    .btn {\r\n        font-size: small !important;\r\n        width: 60px;\r\n        height: 25px;\r\n        line-height: 0px;\r\n    }\r\n\r\n    @media screen and (max-width: 620px) {\r\n        #container {\r\n            width: 250px;\r\n        }\r\n\r\n        \/* .user-info-container {\r\n        grid-column: 1 \/ span 3;\r\n    } *\/\r\n\r\n        .address-container {\r\n            grid-column: 1 \/ span 3;\r\n        }\r\n\r\n        .payment-container {\r\n            grid-column: 1 \/ span 3;\r\n        }\r\n    }\r\n<\/style>\r\n\r\n<form id=\"form\" name=\"form\">\r\n        <div id=\"container\">\r\n            <div class=\"header\">\r\n                <div class=\"label\" style=\"text-align: center;\">\r\n                    <h3>Payment For &#8211; <span id=\"formType\">Other<\/span><\/h3>\r\n                <\/div>\r\n                <div class=\"label\" colspan=\"3\">* Mandatory field<\/div>\r\n            <\/div>\r\n            <div class=\"address-container\">\r\n                <div class=\"form-item\">\r\n                    <div class=\"label\">Reference*<\/div>\r\n                    <div class=\"input\">\r\n                        <input class=\"input-field\" type=\"text\" size=\"30\" name=\"ref\" id=\"ref\" maxlength=\"40\" value=\"\">\r\n                    <\/div>\r\n                <\/div>\r\n                <div class=\"form-item\">\r\n                    <div class=\"label\">Cardholder Name *<\/div>\r\n                    <div class=\"input\">\r\n                        <input class=\"input-field\" type=\"text\" size=\"30\" name=\"name\" id=\"name\" maxlength=\"40\" value=\"\">\r\n                    <\/div>\r\n                <\/div>\r\n                <div class=\"form-item\">\r\n                    <div class=\"label\">Email Address *<\/div>\r\n                    <div class=\"input\">\r\n                        <input class=\"input-field\" type=\"text\" size=\"30\" name=\"email\" id=\"email\" value=\"\">\r\n                    <\/div>\r\n                <\/div>\r\n                <div class=\"form-item\">\r\n                    <div class=\"label\">Telephone *<\/div>\r\n                    <div class=\"input\">\r\n                        <input class=\"input-field\" type=\"text\" size=\"30\" name=\"tel\" id=\"tel\" value=\"\">\r\n                    <\/div>\r\n                <\/div>\r\n                <div class=\"form-item\">\r\n                    <div class=\"label\">Billing Address *<\/div>\r\n                    <div class=\"input\">\r\n                        <input class=\"input-field\" type=\"text\" name=\"address1\" id=\"address1\" value=\"\">\r\n                    <\/div>\r\n                <\/div>\r\n                <div class=\"form-item\">\r\n                    <div class=\"label\"><\/div>\r\n                    <div class=\"input\">\r\n                        <input class=\"input-field\" type=\"text\" name=\"address2\" id=\"address2\" value=\"\">\r\n                    <\/div>\r\n                <\/div>\r\n                <div class=\"form-item\">\r\n                    <div class=\"label\"><\/div>\r\n                    <div class=\"input\">\r\n                        <input class=\"input-field\" type=\"text\" name=\"address3\" id=\"address3\" value=\"\">\r\n                    <\/div>\r\n                <\/div>\r\n                <div class=\"form-item\">\r\n                    <div class=\"label\">Town *<\/div>\r\n                    <div class=\"input\">\r\n                        <input class=\"input-field\" type=\"text\" name=\"town\" id=\"town\" value=\"\">\r\n                    <\/div>\r\n                <\/div>\r\n                <div class=\"form-item\">\r\n                    <div class=\"label\">City *<\/div>\r\n                    <div class=\"input\">\r\n                        <input class=\"input-field\" type=\"text\" name=\"city\" id=\"city\" value=\"\">\r\n                    <\/div>\r\n                    <div class=\"form-item\">\r\n                        <div class=\"label\">Postcode *<\/div>\r\n                        <div class=\"input\">\r\n                            <input class=\"input-field\" type=\"text\" name=\"postcode\" style=\"text-transform:uppercase\" id=\"postcode\" value=\"\">\r\n                        <\/div>\r\n                    <\/div>\r\n                <\/div>\r\n            <\/div>\r\n            <div class=\"payment-container\">\r\n                <div class=\"form-item\">\r\n                    <div class=\"label\">Amount *<\/div>\r\n                    <div class=\"input\">\r\n                        <input class=\"input-field\" type=\"text\" name=\"amount\" id=\"amount\" value=\"\">\r\n                    <\/div>\r\n                <\/div>\r\n                <div class=\"form-item\">\r\n                    <div class=\"label\">Any Additional Information <\/div>\r\n                    <div class=\"input\">\r\n                        <textarea rows=\"5\" name=\"message\" style=\"resize: none;\"><\/textarea>\r\n                    <\/div>\r\n                <\/div>\r\n            <\/div>\r\n            <div class=\"footer\">\r\n                <div class=\"left\">\r\n                    <input class=\"btn-sm\" type=\"button\" onclick=\"history.back();\" style=\"cursor: pointer; border: 1px solid black;\" value=\"Back\">\r\n                    <button class=\"btn-sm\" type=\"reset\" value=\"Reset\" style=\"cursor: pointer; border: 1px solid black;\">Reset<\/button>\r\n                <\/div>\r\n                <div class=\"right\">\r\n                    <input class=\"btn-sm\" id=\"submit\" type=\"submit\" onclick=\"\" style=\"cursor: pointer; border: 1px solid black;\" value=\"Next\">\r\n                <\/div>\r\n            <\/div>\r\n        <\/div>\r\n    <\/form>\r\n    <a href=\"#\" id=\"custom-trigger\" style=\"display: none;\"><\/a>\r\n    <div id=\"custom-html\"><\/div>\n\n\n","protected":false},"excerpt":{"rendered":"<p>Payment For &ndash; Other * Mandatory field Reference* Cardholder Name * Email Address * Telephone * Billing Address * Town * City * Postcode * Amount * Any Additional Information Reset<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[],"class_list":["post-375","page","type-page","status-publish","hentry"],"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/onlinepayments\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":false,"rttpg_excerpt":"Payment For &ndash; Other * Mandatory field Reference* Cardholder Name * Email Address * Telephone * Billing Address * Town * City * Postcode * Amount * Any Additional Information Reset","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/onlinepayments\/wp-json\/wp\/v2\/pages\/375","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/onlinepayments\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/onlinepayments\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/onlinepayments\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/onlinepayments\/wp-json\/wp\/v2\/comments?post=375"}],"version-history":[{"count":18,"href":"https:\/\/apps.nhslothian.scot\/onlinepayments\/wp-json\/wp\/v2\/pages\/375\/revisions"}],"predecessor-version":[{"id":593,"href":"https:\/\/apps.nhslothian.scot\/onlinepayments\/wp-json\/wp\/v2\/pages\/375\/revisions\/593"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/onlinepayments\/wp-json\/wp\/v2\/media?parent=375"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/onlinepayments\/wp-json\/wp\/v2\/categories?post=375"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}