  <form action="{{ action }}" method="post" id="payubiz_form" name="payubiz_form" >
		<input type="hidden" name="key" value="{{ key }}" />
		<input type="hidden" name="txnid" value="{{ txnid }}" />
		<input type="hidden" name="amount" value="{{ amount }}" />
		<input type="hidden" name="productinfo" value="{{ productinfo }}" />
		<input type="hidden" name="firstname" value="{{ firstname }}" />
		<input type="hidden" name="Lastname" value="{{ Lastname }}" />
		<input type="hidden" name="Zipcode" value="{{ Zipcode }}" />
		<input type="hidden" name="email" value="{{ email }}" />
		<input type="hidden" name="phone" value="{{ phone }}" />
		<input type="hidden" name="surl" value="{{ surl }}" />
		<input type="hidden" name="Furl" value="{{ Furl }}" />
		<input type="hidden" name="curl" value="{{ curl }}" />
		<input type="hidden" name="Hash" value="{{ Hash }}" />
		
		<input type="hidden" name="address1" value="{{ address1 }}" />
        <input type="hidden" name="address2" value="{{ address2 }}" />
        <input type="hidden" name="city" value="{{ city }}" />
        <input type="hidden" name="country" value="{{ country }}" />
        <input type="hidden" name="state" value="{{ state }}" />
        <input type="hidden" name="pg" value="{{ pg }}" />
        <input type="hidden" name="bankcode" value="{{ bankcode }}" />
		<input type="hidden" name="udf5" value="{{ udf5 }}" />
		<div class="buttons">
    <div class="pull-right"><input type="submit" value="{{ button_confirm }}" class="btn btn-primary" /></div>
  </div>
	</form>	
	
	