        <div id="wallet_balance" style="margin-bottom: 20px; font-weight: bold;">
            
            Current Wallet Balance:            
            <span class="woocommerce-Price-amount amount"><bdi>0,00&nbsp;<span class="woocommerce-Price-currencySymbol">EGP</span></bdi></span>        </div>
        <form id="healtypay-pro-form" method="post">
            <div id="search_section">
                <label for="doctor_search">Search Doctor by Code:</label>
                <div style="position: relative;">
                    <input type="text" id="doctor_search" name="doctor_search" placeholder="Please enter the doctor code here" required>
                    <div id="loading-icon" style="display: none; position: absolute; right: 10px; top: 50%; transform: translateY(-50%);">
                        <img src="https://clinic-card.com/wp-content/plugins/healtypay-pro-1/assets/img/loading.gif" alt="Loading" style="width: 20px;">
                    </div>
                </div>
            </div>
            <div id="doctor_results" style="display: none; border: 1px solid #ccc; padding: 10px; background-color: #f9f9f9; max-height: 150px; overflow-y: auto;"></div>
            <p id="no_results_message" style="display:none; color: red;">Please check the doctor code you entered.</p>
    
            <div id="doctor_info" style="display:none;">
                <label for="doctor_code">Doctor Code:</label>
                <input type="text" id="doctor_code" name="doctor_code" readonly>
    
                <label for="doctor_name">Doctor Name:</label>
                <input type="text" id="doctor_name" name="doctor_name" readonly>
    
                <label for="doctor_phone">Doctor Phone:</label>
                <input type="text" id="doctor_phone" name="doctor_phone" readonly>
    
                <label for="amount">Enter Amount:</label>
                <input type="number" id="amount" name="amount" value="0" readonly>
    
                <input type="button" id="submit_payment" value="Submit Payment">
                <button type="button" id="new_request" style="margin-left: 10px; background-color: #007bff; color: white; padding: 10px 15px; border: none; border-radius: 5px; cursor: pointer; display: flex; align-items: center;">
                    <img src="https://clinic-card.com/wp-content/plugins/healtypay-pro-1/assets/img/refresh-icon.png" alt="New Request" style="width: 20px; margin-right: 5px;">
                    New Request                </button>
            </div>
            <div id="payment_success_message" style="display:none; text-align: center; padding: 20px; background-color: #e9ffe9; border: 1px solid #b6ffb6;">
                <h2>Thank you!</h2>
                <p>Your request has been successfully submitted to the doctor.</p>
                <p>Your confirmation code is: <strong id="confirmation_code_display"></strong></p>
                <p>Please keep this code safe and provide it to the doctor to confirm your request.</p>
                <a href="https://clinic-card.com/en/my-requests/" style="display: inline-block; padding: 10px 20px; background-color: #007bff; color: white; text-decoration: none; border-radius: 5px;">View Your Requests</a>
            </div>
    
            <!-- Popup لـ Bootstrap -->
            <div class="modal fade" id="payment_error_modal" tabindex="-1" role="dialog" aria-labelledby="paymentErrorModalLabel" aria-hidden="true">
              <div class="modal-dialog modal-dialog-centered" role="document" style="z-index: 1055;">
                <div class="modal-content">
                  <div class="modal-header">
                    <h5 class="modal-title" id="paymentErrorModalLabel">Error</h5>
                    <button type="button" class="close" data-dismiss="modal" aria-label="Close">
                      <span aria-hidden="true">&times;</span>
                    </button>
                  </div>
                  <div class="modal-body text-center">
                    <span style="color: red; font-size: 50px;">&#10060;</span>
                    <p id="error_message_text" style="margin-top: 20px; font-size: 18px;"></p>
                  </div>
                  <div class="modal-footer">
                    <button type="button" class="btn btn-secondary" data-dismiss="modal">Close</button>
                  </div>
                </div>
              </div>
            </div>
        </form>
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