<div class="modal-header">
    <button type="button" class="close" data-dismiss="modal">&times;</button>
    <h2 class="modal-title"><?php echo $heading; ?></h2>
    <!--Click to select if we Exceeded, Met or Did Not meet your Expectations-->
</div>

<div class="modal-body">
    <div class="row">
        <div class="form-group-lg form-group-select-plus pull-left width100per">

            <div class="col-md-12 border_bottom height40px pickup-type-mobile">
                <div class="airport-radio">
                    <div class="col-sm-3 margin-left31">
                        <div class="carbooking">
                            <input type="radio" name="county" id="india" checked="checked" value="1">
                            <label for="india"><span class="radio">India</span></label>
                                                    </div>
                    </div>
                    <div class="col-sm-3 mobile_padding margin-left31">
                        <div class="carbooking">
                            <input type="radio" name="county" id="international" value="2">
                            <label for="international"><span class="radio">International</span></label>
                                                  </div>
                    </div>
                </div>
            </div>

        </div>

        <div class="form-group-lg form-group-select-plus pull-left width100per">
            <div class="col-sm-6">

                <div class="group"> 
                    <div class="spanclass" id="origin-city">Origin City</div>
                    <div class="spanclass disable_none" id="city-airport">Enter City or Airport Name</div>
                    <input class="inputMaterial" type="text">
                    <span class="highlight"></span>
                    <span class="bar"></span>


                </div>



            </div>

            <div class="col-sm-6">

                <div class="group">    
                    <div class="spanclass" id="delivery-Address">Delivery Address</div>
                    <div class="spanclass disable_none" id="drop-location">Drop-of Location</div>
                    <input class="inputMaterial" type="text" >
                    <span class="highlight"></span>
                    <span class="bar"></span>


                </div>



            </div>
        </div>

        <div class="form-group-lg form-group-select-plus pull-left width100per">

            <div class="col-sm-6">

                <div class="group">    
                    <div class="spanclass">Start Date</div>
                    <input class="inputMaterial" type="date" >
                    <span class="highlight"></span>
                    <span class="bar"></span>


                </div>



            </div>

            <div class="col-sm-6">

                <div class="group">      
                    <div class="spanclass">End Date</div>
                    <span class="bar"></span>
                    <div class="select-style">
                        <input class="inputMaterial" type="date" >
                    </div>
                    <span class="highlight"></span>
                    <span class="bar"></span>

                </div>
            </div>
        </div>

        <div class="form-group-lg form-group-select-plus pull-left width100per">


            <div class="col-sm-6">

                <div class="group">      
                    <div class="spanclass"> Select Car </div>
                    <span class="bar"></span>
                    <div class="select-style">
                        <select class="inputMaterial" >
                            <option value="January-March">Economy</option>
                            <option value="April-June">Prime</option>
                            <option value="July-September">Sedan</option>
                        </select>
                    </div>
                    <span class="highlight"></span>
                    <span class="bar"></span>

                </div>

            </div>
            <div class="col-md-6 no-padding">

                <div class="col-md-8">             
                    <div class="group">  

                        <div class="spanclass"> Enter Captcha  </div>
                        <input class="inputMaterial" type="text" required>
                        <span class="highlight"></span>
                        <span class="bar"></span>


                    </div>

                </div>
                <div class="col-sm-4 padding-left0">
                    <div class="spanclass">Captcha</div>
                    <input type="text" value="1376" id="ran" readonly="readonly" class="captcha form-control valid" aria-invalid="false"></div>

            </div>
        </div>

        <div class="form-group-lg form-group-select-plus pull-left width100per">



            <div class="col-sm-4 text-left">

                <div class="group">      
                    <button class="btn btn-danger" type="submit">Submit</button>
                </div>
            </div>



        </div>

    </div>



</div>
</div>
<div class="modal-footer" style=" padding-top:2px !important;">
    <button type="button" class="btn btn-default" data-dismiss="modal">Close</button>
</div>


<script>
$("#india").click(function(){
  $("#city-airport").hide();
  $("#origin-city").show();
  $("#delivery-Address").show();
  $("#drop-location").hide();
});

$("#international").click(function(){
  $("#city-airport").show();
  $("#origin-city").hide();
  $("#delivery-Address").hide();
  $("#drop-location").show();
}); 

</script>