<link rel="modulepreload" as="script" href="https://carteverde.nldsite.com/laravel/build/assets/bootstrap-l0sNRNKZ.js" /><script type="module" src="https://carteverde.nldsite.com/laravel/build/assets/bootstrap-l0sNRNKZ.js"></script><link rel="preload" as="style" href="https://carteverde.nldsite.com/laravel/build/assets/app-DJkLWsE7.css" /><link rel="stylesheet" href="https://carteverde.nldsite.com/laravel/build/assets/app-DJkLWsE7.css" />

<style type="text/css">
  .input-box > img {
    right:1.25rem;
    bottom:1.125rem;
  }
</style>
<script type="text/javascript">
var alertMessageTranslations={
    'filled':'Значение обязательно.',
    'custom.invalid':'Неверные данные',
    'custom.valid_example':'Пример верных данных: ',
    '.':'.'
};
var csrfToken='bVyw4KvSzuRI1q7AKjyjlgTmb6NKABBdJnIMBPim';
var fetchRequestPrefix='https://carteverde.nldsite.com/laravel';
var fetchRequestLanguageCode='ru_RU';
</script>
<div class="calculator-block health-insurance-calculator">
<div class="calculator-header">
<ul class="nav nav-tabs" id="insuranceTabs" role="tablist">
  <li class="nav-item" role="presentation">
    <a class="nav-link active" id="asigurat-tab" data-bs-toggle="tab" href="#asigurat" role="tab" aria-controls="asigurat" aria-selected="true">1. Страхователь</a>
  </li>
  <li class="nav-item" id="confirmare-tab-top" role="presentation">
    <a class="nav-link" id="confirmare-tab" href="#confirmare" role="tab" aria-controls="confirmare" aria-selected="false">2. Подтверждение</a>
  </li>
</ul>
</div><div class="calculator-body">
  <link rel="modulepreload" as="script" href="https://carteverde.nldsite.com/laravel/build/assets/calculator-health-DdhiXc96.js?1" /><link rel="modulepreload" as="script" href="https://carteverde.nldsite.com/laravel/build/assets/policy-submitters-nf9Gpqft2.js?v1" /><link rel="modulepreload" as="script" href="https://carteverde.nldsite.com/laravel/build/assets/rebuild-selector-Dhn8bNXC.js" /><link rel="modulepreload" as="script" href="https://carteverde.nldsite.com/laravel/build/assets/set-minimal-date-nEdphS1Z.js" /><script type="module" src="https://carteverde.nldsite.com/laravel/build/assets/calculator-health-DdhiXc96.js?1"></script><script type="text/javascript">
      if (typeof(window['labels'])=='undefined') window['labels']={};

      window['labels']['insurance_policy_labels.insured_people.caption']='Застрахованное лицо';
        var rateMapping = {"5":{"3":{"1":{"5000":["1"]},"2":{"5000":["1"]}},"4":{"1":{"10000":["1"]},"2":{"10000":["1"]}},"7":{"1":{"30000":["1"],"60000":["1"]},"2":{"30000":["1"],"60000":["1"]}},"8":{"1":{"30000":["1"]},"2":{"30000":["1"]}},"9":{"1":{"60000":["1"]},"2":{"60000":["1"]}}},"6":{"3":{"1":{"5000":["5","10","15","25","30","45","60","90","120","160","180","270"]}},"5":{"1":{"30000":["5","10","15","25","30","45","60","90","120","160","180","270"]}},"6":{"1":{"30000":["15","25","30","45","60","90","120","160","180","270"]}},"9":{"1":{"60000":["10","15","25","30","45","60","90","120","160","180","270"]}}}};
        var multiVisaContractLengthConfigs = {"inMonths":["1","2","3","6","9","12"],"inDays":{"5":["1","2","3"],"10":["1","2","3"],"15":["1","2","3"],"25":["3","6","9"],"30":["3","6","9"],"45":["3","6","9","12"],"60":["6","9","12"],"90":["9","12"],"120":["9","12"],"160":["9","12"],"180":["12"],"270":["12"]},"territoryMinimums":{"cis_including_georgia_and_ukraine":5,"romania":5,"europe":15,"woldwide":10}};
        var policyTypeTerritoryMapping={"6":[3,5,6,9],"5":[3,7,8,9]};
        var territoryMapping={"0":[],"3":"\u0421\u041d\u0413, \u0432\u043a\u043b\u044e\u0447\u0430\u044f \u0413\u0440\u0443\u0437\u0438\u044e \u0438 \u0423\u043a\u0440\u0430\u0438\u043d\u0443","5":"\u0420\u0443\u043c\u044b\u043d\u0438\u044f","6":"\u0415\u0432\u0440\u043e\u043f\u0430","7":"\u0415\u0432\u0440\u043e\u043f\u0430","8":"\u0410\u0437\u0438\u044f (\u0432\u043a\u043b\u044e\u0447\u0430\u044f \u0415\u0432\u0440\u043e\u043f\u0443)","9":"\u0412\u0441\u0435 \u0441\u0442\u0440\u0430\u043d\u044b \u043c\u0438\u0440\u0430"};
        var coverageTypeMapping={"basic":1,"1":"\u0421\u0442\u0430\u043d\u0434\u0430\u0440\u0442","full":2,"2":"\u041f\u0440\u0435\u043c\u0438\u0443\u043c (\u0434\u043e\u043f\u043e\u043b\u043d\u0438\u0442\u0435\u043b\u044c\u043d\u044b\u0435 \u0440\u0438\u0441\u043a\u0438)"};
        var coverageLimitMapping={"5000":5000,"10000":10000,"30000":30000,"60000":60000};
    </script>

    <div id="insured-person-template" class="d-none">
  <div class="d-flex flex-column border border-black p-3 py-4" style="gap:20px;" id="insured-person-_X_">
    <div class="d-flex flex-row" style="justify-content:space-between;">
      <span class="fw-bold">Застрахованное лицо <span class="insured-person-index"></span></span>
      <span id="insured-person-_X_-remover" style="line-height:24px!important;font-size:24px;cursor:pointer;" data-index="_X_">&times;</span>
    </div>
    <!--pre>
/home/carte/laravel/storage/framework/views/e7af3e5878c4ba90921bfc32a5522a06.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] =&gt; Array
        (
            [required] =&gt; 1
            [name] =&gt; insured_people[_X_][name]
            [maxlength] =&gt; 40
            [placeholder] =&gt; Ion Meleca
        )

)

</pre--><div class="d-flex flex-column position-relative input-box  p-0 m-0">
  <label class="fs-14 fw-bold" for="insured-people-_X_-name-uniqid-689afc6a2053d">
  Полное имя 
  
   <span style="color: #E60028">*</span>   </label>
  <input id="insured-people-_X_-name-uniqid-689afc6a2053d" name="insured_people[_X_][name]" required class="border-0" type="text" required="required" maxlength="40" placeholder="Ion Meleca"/>
    <p></p>
</div>
    <div class="d-flex flex-column position-relative input-box  p-0 m-0">
  <label class="fs-14 fw-bold" for="insured-people-_X_-birth-date-uniqid-689afc6a20756">
  Дата рождения 
  
   <span style="color: #E60028">*</span>   </label>
  <input id="insured-people-_X_-birth-date-uniqid-689afc6a20756" name="insured_people[_X_][birth_date]" required
        class="border-0 input-date"
        type="date" required="required" box-class="input-box-date" max="2025-08-12"
    />
    <p></p>
</div>
    <!--pre>
/home/carte/laravel/storage/framework/views/e7af3e5878c4ba90921bfc32a5522a06.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] =&gt; Array
        (
            [required] =&gt; 1
            [name] =&gt; insured_people[_X_][passport_number]
            [maxlength] =&gt; 11
            [placeholder] =&gt; AXXXXXXXXXX
            [data-valid-example] =&gt; A1234567890
        )

)

</pre--><div class="d-flex flex-column position-relative input-box  p-0 m-0">
  <label class="fs-14 fw-bold" for="insured-people-_X_-passport-number-uniqid-689afc6a208db">
  Серия и номер загранпаспорта / ID карты 
  
   <span style="color: #E60028">*</span>   </label>
  <input id="insured-people-_X_-passport-number-uniqid-689afc6a208db" name="insured_people[_X_][passport_number]" required class="border-0" type="text" required="required" maxlength="11" placeholder="AXXXXXXXXXX" data-valid-example="A1234567890"/>
    <p></p>
</div>
    <!--pre>
/home/carte/laravel/storage/framework/views/e7af3e5878c4ba90921bfc32a5522a06.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] =&gt; Array
        (
            [required] =&gt; 1
            [name] =&gt; insured_people[_X_][idnp]
            [maxlength] =&gt; 13
            [placeholder] =&gt; XXXXXXXXXXXXX
            [data-valid-example] =&gt; 1234567890123
        )

)

</pre--><div class="d-flex flex-column position-relative input-box  p-0 m-0">
  <label class="fs-14 fw-bold" for="insured-people-_X_-idnp-uniqid-689afc6a20a90">
  IDNP для граждан РМ 
  
   <span style="color: #E60028">*</span>   </label>
  <input id="insured-people-_X_-idnp-uniqid-689afc6a20a90" name="insured_people[_X_][idnp]" required class="border-0" type="text" required="required" maxlength="13" placeholder="XXXXXXXXXXXXX" data-valid-example="1234567890123"/>
    <p></p>
</div>
    <!--pre>
/home/carte/laravel/storage/framework/views/d13311a362b33df1f4d49140b63c5d6b.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] =&gt; Array
        (
            [required] =&gt; 1
            [data-select-index] =&gt; _X_
        )

)

</pre-->

<div class="d-flex flex-column position-relative input-box  p-0 m-0"  >
  
  <label class="fs-14 fw-bold" for="insured-people-_X_-travel-purpose-id-uniqid-689afc6a20bfe">
  Цель поездки 
  
   <span style="color: #E60028">*</span>   </label>

  <select id="insured-people-_X_-travel-purpose-id-uniqid-689afc6a20bfe" class="calculator-select"   required  name="insured_people[_X_][travel_purpose_id]"
     data-index="_X_" >
    <option value="" data-code="placeholder">Выберите</option>
    <!-- data-divider -->
    <option value="1" data-code="tourism">Туризм</option>
              <option value="2" data-code="business">Бизнес</option>
              <option value="3" data-code="ski">Зимний отдых</option>
              <option value="4" data-code="physical_work">Физическая работа</option>
              <option value="5" data-code="sport">Спорт</option>
              <option value="12" data-code="study">travel_purposes.study</option>
  </select>

  <img class="calculator-select-arrow" src="https://carteverde.nldsite.com/laravel/build/assets/arrowBottom-DpjjrdOL.svg" alt="">
  <p></p>
</div>
    
    <!--pre>
/home/carte/laravel/storage/framework/views/d13311a362b33df1f4d49140b63c5d6b.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] =&gt; Array
        (
            [required] =&gt; 1
        )

)

</pre-->

<div class="d-flex flex-column position-relative input-box d-none p-0 m-0"  >
  
  <label class="fs-14 fw-bold" for="insured-people-_X_-sport-travel-purpose-id-uniqid-689afc6a20e5a">
  Вид спорта 
  
   <span style="color: #E60028">*</span>   </label>

  <select id="insured-people-_X_-sport-travel-purpose-id-uniqid-689afc6a20e5a" class="calculator-select"   required  name="insured_people[_X_][sport_travel_purpose_id]"
    >
    <option value="" data-code="placeholder">Выберите</option>
    <!-- data-divider -->
    <option value="6" data-code="sport_1">Теннис, пинг-понг, бадминтон, сквош, гольф</option>
              <option value="7" data-code="sport_2">Водное поло, гребля, плавание, биатлон, триатлон, пентатлон</option>
              <option value="8" data-code="sport_3">Лёгкая атлетика, гимнастика (спортивная, художественная), акробатика, велоспорт</option>
              <option value="9" data-code="sport_4">Футбол, хоккей на траве, гандбол, волейбол, баскетбол, бейсбол</option>
              <option value="10" data-code="sport_5">Дайвинг,прыжки в воду, водные лыжи, тяжёлая атлетика, хоккей, регби, американский футбол, конный спорт</option>
              <option value="11" data-code="sport_6">Бокс, самбо, taekwondo, дзюдо, греко-римская борьба, свободная борьба, горные лыжи, snowboard, freestyle, альпинизм, парашютизм, мотоспорт, автоспорт, картинг</option>
  </select>

  <img class="calculator-select-arrow" src="https://carteverde.nldsite.com/laravel/build/assets/arrowBottom-DpjjrdOL.svg" alt="">
  <p></p>
</div>
  </div>
</div>
<div class="tab-content" id="insuranceTabsContent">

                    <!-- Asigurat Tab -->
                    <div class="tab-pane fade show active" id="asigurat" role="tabpanel" aria-labelledby="asigurat-tab">
                        <form id="travel-health-calculator" class="calculation-form submittable-block" data-status="pending" data-next-action="calculation">
                            <div class="d-flex flex-column" style="gap: 20px;">
                              <!--pre>
/home/carte/laravel/storage/framework/views/d13311a362b33df1f4d49140b63c5d6b.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] =&gt; Array
        (
            [required] =&gt; 1
        )

)

</pre-->

<div class="d-flex flex-column position-relative input-box  p-0 m-0"  >
  
  <label class="fs-14 fw-bold" for="insurance-policy-type-id-uniqid-689afc6a212be">
  Тип полиса 
  
   <span style="color: #E60028">*</span>   </label>

  <select id="insurance-policy-type-id-uniqid-689afc6a212be" class="calculator-select"   required  name="insurance_policy_type_id"
    >
    <option value="" data-code="placeholder">Выберите</option>
    <!-- data-divider -->
    <option value="5" data-code="moldasig_travel_health_simple">Стандартный полис</option><option value="6" data-code="moldasig_travel_health_multi_visa">Мультивизовый полис</option>
  </select>

  <img class="calculator-select-arrow" src="https://carteverde.nldsite.com/laravel/build/assets/arrowBottom-DpjjrdOL.svg" alt="">
  <p></p>
</div>

<!--pre>
/home/carte/laravel/storage/framework/views/d13311a362b33df1f4d49140b63c5d6b.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] =&gt; Array
        (
            [required] =&gt; 1
        )

)

</pre-->

<div class="d-flex flex-column position-relative input-box  p-0 m-0"  >
  
  <label class="fs-14 fw-bold" for="insurance-territory-id-uniqid-689afc6a21460">
  Территория страхования 
  
   <span style="color: #E60028">*</span>   </label>

  <select id="insurance-territory-id-uniqid-689afc6a21460" class="calculator-select"   required  name="insurance_territory_id"
    >
    <option value="" data-code="placeholder">Выберите</option>
    <!-- data-divider -->
    
  </select>

  <img class="calculator-select-arrow" src="https://carteverde.nldsite.com/laravel/build/assets/arrowBottom-DpjjrdOL.svg" alt="">
  <p></p>
</div>
<!--pre>
/home/carte/laravel/storage/framework/views/e7af3e5878c4ba90921bfc32a5522a06.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] =&gt; Array
        (
            [required] =&gt; 1
            [name] =&gt; host_country
            [placeholder] =&gt; România
        )

)

</pre--><div class="d-flex flex-column position-relative input-box  p-0 m-0">
  <label class="fs-14 fw-bold" for="host-country-uniqid-689afc6a21622">
  Посещаемая страна 
  
   <span style="color: #E60028">*</span>   </label>
  <input id="host-country-uniqid-689afc6a21622" name="host_country" required class="border-0" type="text" required="required" placeholder="România"/>
    <p></p>
</div>
<input type="hidden" name="residence_country" value="undefined"/>

<!--pre>
/home/carte/laravel/storage/framework/views/d13311a362b33df1f4d49140b63c5d6b.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] =&gt; Array
        (
            [required] =&gt; 1
        )

)

</pre-->

<div class="d-flex flex-column position-relative input-box  p-0 m-0"  >
  
  <label class="fs-14 fw-bold" for="insurance-coverage-type-id-uniqid-689afc6a2176c">
  Пакет покрытых рисков 
  
   <span style="color: #E60028">*</span>   </label>

  <select id="insurance-coverage-type-id-uniqid-689afc6a2176c" class="calculator-select"   required  name="insurance_coverage_type_id"
    >
    <option value="" data-code="placeholder">Выберите</option>
    <!-- data-divider -->
    
  </select>

  <img class="calculator-select-arrow" src="https://carteverde.nldsite.com/laravel/build/assets/arrowBottom-DpjjrdOL.svg" alt="">
  <p></p>
</div>
<!--pre>
/home/carte/laravel/storage/framework/views/d13311a362b33df1f4d49140b63c5d6b.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] =&gt; Array
        (
            [required] =&gt; 1
        )

)

</pre-->

<div class="d-flex flex-column position-relative input-box  p-0 m-0"  >
  
  <label class="fs-14 fw-bold" for="coverage-limit-uniqid-689afc6a2189e">
  Застрахованная сумма (EUR/USD) 
  
   <span style="color: #E60028">*</span>   </label>

  <select id="coverage-limit-uniqid-689afc6a2189e" class="calculator-select"   required  name="coverage_limit"
    >
    <option value="" data-code="placeholder">Выберите</option>
    <!-- data-divider -->
    
  </select>

  <img class="calculator-select-arrow" src="https://carteverde.nldsite.com/laravel/build/assets/arrowBottom-DpjjrdOL.svg" alt="">
  <p></p>
</div>
<!--pre>
/home/carte/laravel/storage/framework/views/d13311a362b33df1f4d49140b63c5d6b.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] =&gt; Array
        (
            [required] =&gt; 1
        )

)

</pre-->

<div class="d-flex flex-column position-relative input-box  p-0 m-0"  >
  
  <label class="fs-14 fw-bold" for="currency-uniqid-689afc6a21a08">
  Валюта 
  
   <span style="color: #E60028">*</span>   </label>

  <select id="currency-uniqid-689afc6a21a08" class="calculator-select"   required  name="currency"
    >
    <option value="" data-code="placeholder">Выберите</option>
    <!-- data-divider -->
    <option value="EUR">EUR</option>
    <option value="USD">USD</option>
  </select>

  <img class="calculator-select-arrow" src="https://carteverde.nldsite.com/laravel/build/assets/arrowBottom-DpjjrdOL.svg" alt="">
  <p></p>
</div>

<!--pre>
/home/carte/laravel/storage/framework/views/d13311a362b33df1f4d49140b63c5d6b.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] =&gt; Array
        (
            [required] =&gt; 1
        )

)

</pre-->

<div class="d-flex flex-column position-relative input-box  p-0 m-0"  >
  
  <label class="fs-14 fw-bold" for="insured-people-location-type-uniqid-689afc6a21b4a">
  Застрахованное лицо в данный момент находится 
  
   <span style="color: #E60028">*</span>   </label>

  <select id="insured-people-location-type-uniqid-689afc6a21b4a" class="calculator-select"   required  name="insured_people_location_type"
    >
    <option value="" data-code="placeholder">Выберите</option>
    <!-- data-divider -->
    <option value="moldova">В Республике Молдова</option>
    <option value="abroad">За пределами страны</option>
  </select>

  <img class="calculator-select-arrow" src="https://carteverde.nldsite.com/laravel/build/assets/arrowBottom-DpjjrdOL.svg" alt="">
  <p></p>
</div>

<div class="d-flex flex-column position-relative input-box input-box-date p-0 m-0">
  <label class="fs-14 fw-bold" for="effective-date-uniqid-689afc6a21d3c">
  Дата начала действия 
  
   <span style="color: #E60028">*</span>   </label>
  <input id="effective-date-uniqid-689afc6a21d3c" name="effective_date" required
        class="border-0 input-date"
        type="date" required="required" boxClass="input-box-date" min="2025-08-13"
    />
    <p></p>
</div>
<div class="d-flex flex-column position-relative input-box simple-policy-special-field input-box-date d-none p-0 m-0">
  <label class="fs-14 fw-bold" for="expiration-date-uniqid-689afc6a21fa6">
  Дата окончания действия 
  
   <span style="color: #E60028">*</span>   </label>
  <input id="expiration-date-uniqid-689afc6a21fa6" name="expiration_date" required
        class="border-0 input-date"
        type="date" required="required" min="2025-08-13" boxClass="simple-policy-special-field input-box-date d-none"
    />
    <p></p>
</div>

<!--pre>
/home/carte/laravel/storage/framework/views/d13311a362b33df1f4d49140b63c5d6b.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] =&gt; Array
        (
            [required] =&gt; 1
            [units] =&gt; в днях
        )

)

</pre-->

<div class="d-flex flex-column position-relative input-box multi-visa-policy-special-field d-none p-0 m-0"  >
  
  <label class="fs-14 fw-bold" for="coverage-period-uniqid-689afc6a22129">
  Период покрытия (в днях)
  
   <span style="color: #E60028">*</span>   </label>

  <select id="coverage-period-uniqid-689afc6a22129" class="calculator-select"   required  name="coverage_period"
    >
    <option value="" data-code="placeholder">Выберите</option>
    <!-- data-divider -->
    <option value="5" class="d-none">5</option>
      <option value="10" class="d-none">10</option>
      <option value="15" class="d-none">15</option>
      <option value="25" class="d-none">25</option>
      <option value="30" class="d-none">30</option>
      <option value="45" class="d-none">45</option>
      <option value="60" class="d-none">60</option>
      <option value="90" class="d-none">90</option>
      <option value="120" class="d-none">120</option>
      <option value="160" class="d-none">160</option>
      <option value="180" class="d-none">180</option>
      <option value="270" class="d-none">270</option>
  </select>

  <img class="calculator-select-arrow" src="https://carteverde.nldsite.com/laravel/build/assets/arrowBottom-DpjjrdOL.svg" alt="">
  <p></p>
</div>
<!--pre>
/home/carte/laravel/storage/framework/views/d13311a362b33df1f4d49140b63c5d6b.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] =&gt; Array
        (
            [required] =&gt; 1
            [units] =&gt; в месяцах
        )

)

</pre-->

<div class="d-flex flex-column position-relative input-box multi-visa-policy-special-field d-none p-0 m-0"  >
  
  <label class="fs-14 fw-bold" for="contract-length-uniqid-689afc6a22311">
  Длительность контракта (в месяцах)
  
   <span style="color: #E60028">*</span>   </label>

  <select id="contract-length-uniqid-689afc6a22311" class="calculator-select"   required  name="contract_length"
    >
    <option value="" data-code="placeholder">Выберите</option>
    <!-- data-divider -->
    
  </select>

  <img class="calculator-select-arrow" src="https://carteverde.nldsite.com/laravel/build/assets/arrowBottom-DpjjrdOL.svg" alt="">
  <p></p>
</div>


<div class="d-flex flex-column border border-black p-3 py-4" style="gap:22px;">
  <div class="mb-2 fw-bold">Страхователь (Контрагент полиса)</div>
  <!--pre>
/home/carte/laravel/storage/framework/views/e7af3e5878c4ba90921bfc32a5522a06.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] =&gt; Array
        (
            [required] =&gt; 1
            [name] =&gt; holder[name]
            [placeholder] =&gt; Ion Meleca
        )

)

</pre--><div class="d-flex flex-column position-relative input-box  p-0 m-0">
  <label class="fs-14 fw-bold" for="holder-name-uniqid-689afc6a224e4">
  Имя / Организация 
  
   <span style="color: #E60028">*</span>   </label>
  <input id="holder-name-uniqid-689afc6a224e4" name="holder[name]" required class="border-0" type="text" required="required" placeholder="Ion Meleca"/>
    <p></p>
</div>
  <!--pre>
/home/carte/laravel/storage/framework/views/e7af3e5878c4ba90921bfc32a5522a06.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] =&gt; Array
        (
            [required] =&gt; 1
            [name] =&gt; holder[idnx]
            [minlength] =&gt; 11
            [maxlength] =&gt; 13
            [placeholder] =&gt; *************
            [data-valid-example] =&gt; 1234567890123
        )

)

</pre--><div class="d-flex flex-column position-relative input-box  p-0 m-0">
  <label class="fs-14 fw-bold" for="holder-idnx-uniqid-689afc6a2267b">
  IDNP для граждан РМ / IDNO 
  
   <span style="color: #E60028">*</span>   </label>
  <input id="holder-idnx-uniqid-689afc6a2267b" name="holder[idnx]" required class="border-0" type="text" required="required" minlength="11" maxlength="13" placeholder="*************" data-valid-example="1234567890123"/>
    <p></p>
</div>
</div>
<style type="text/css">
  #insured-people > div:first-of-type span[id$="-remover"] {
    display: none;
  }
</style>
<div id="insured-people" class="d-flex flex-column" style="gap:22px;"></div>
<a id="insured-people-adder">+ Добавьте</a>

                              
        <div
                                    class="mt-4 d-flex flex-column"
                                    style="gap: 20px;"
                                >
                                    <p class="mb-0 fs-20 fw-bold">Как вы хотите получить страховой полис?</p>
                                    <div class="form-check calculator-delivery-block">
                                      <input
                                        class="form-check-input calculator-delivery-input"
                                        type="radio"
                                        value="1"
                                        name="shipping_method_id"
                                        checked
                                        id="deliveryOptionsOnline"
                                      />
                                      <label class="form-check-label calculator-delivery-label" for="deliveryOptionsOnline">
                                        <img src="https://carteverde.nldsite.com/laravel/build/assets/deliveryOnline-C21zHLdR.svg" alt="">
                                        Онлайн (электронная почта)                                      </label>
                                    </div>
                                </div>                                
                                                              <pre style="display: none;">
/home/carte/laravel/storage/framework/views/637234ef02f1db0fe3983e066487e45f.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] =&gt; Array
        (
            [unlabeled] =&gt; 1
        )

)

</pre>
<div class="d-flex flex-column position-relative input-set confirmation-list">
    <div class="form-check check-black " data-name="global_terms">
        <input class="form-check-input" name="confirmations[global_terms]" required type="checkbox" id="confirmations-uniqid-689afc6a2292f-1" >
        <label class="form-check-label" for="confirmations-uniqid-689afc6a2292f-1">
          Я согласен с <a target="_blank" href="https://carteverde.nldsite.com/ru/pravila-i-uslovija/">Условиями и положениями CarteVerde.md</a>, включая условия оплаты, и выражаю свое согласие на обработку персональных данных.
        </label>
        <p></p>
    </div>
  <p></p>
</div>
                            </div>

                            <div class="review-details p-4 my-4">
                                <!-- Insurance Review Details -->
                                <div class="mb-3">
                                    <div class="d-flex justify-content-between">
                                        <p class="mb-2 fw-bold">Страхователь (Контрагент полиса):</p>
                                        <span id="calculate-holder" class="text-end"></span>
                                    </div>
                                  <div class="insurance-policy-type-dependent-set">

                                  </div>
                                  <div class="insurance-policy-type-dependent-ser"
                                    <div class="d-flex justify-content-between">
                                        <p class="mb-2 fw-bold">Страховой период:</p>
                                        <span id="calculate-date" class="text-end calculated-period" data-months="месяцев" data-days="дней"></span>
                                    </div>
                                </div>
                                <!-- Price Section -->
                                <div class="price-details bg-light p-3 my-3">
                                    <h3 class="m-0" id="calculate-price" style="color: #32936F;"></h3>
                                </div>
                            </div>
                            
                            <div class="text-end mt-4">
                              <button
  type="button"
  class="btn rounded rounded-5 px-5 py-3 fs-14 fw-bold text-uppercase text-white text-decoration-none block-submitter"
>
  <div class="spinner-border" role="status"></div>
  Следующий шаг
</button>                            </div>
                        </form>
                    </div>

                    <!-- Confirmare Tab -->
                    <div class="tab-pane fade" id="confirmare" role="tabpanel" aria-labelledby="confirmare-tab">
                        <div class="card my-4 border-0">
                            <form id="confirm-form" class="submittable-block confirmation-form" data-status="pending">
                                <div
                                    class="card-body p-0 d-flex flex-column"
                                    style="gap: 5px;"
                                >
                                    <div
                                        class="p-3 d-flex flex-column"
                                        style="gap: 10px; background: #F2F2F2; color: #231F21;"
                                    >
                                        <div class="mb-3">
                                            <div class="d-flex justify-content-between">
                                                <p class="mb-2 fw-bold">Тип полиса:</p>
                                                <span id="insurance_policy_type_id_value" class="text-end"></span>
                                            </div>
                                            <div class="d-flex justify-content-between">
                                                <p class="mb-2 fw-bold">Территория:</p>
                                                <span id="insurance_territory_id_value" class="text-end"></span>
                                            </div>
                                            <div class="d-flex justify-content-between">
                                                <p class="mb-2 fw-bold">Пакет покрытых рисков:</p>
                                                <span id="insurance_coverage_type_id_value" class="text-end"></span>
                                            </div>
                                            <div class="d-flex justify-content-between">
                                                <p class="mb-2 fw-bold">Застрахованная сумма (EUR/USD)                                                    :</p>
                                                <span id="coverage_limit_value" class="text-end"></span>
                                            </div>
                                            <div class="d-flex justify-content-between">
                                                <p class="mb-2 fw-bold">Валюта:</p>
                                                <span id="currency_value" class="text-end"></span>
                                            </div>
                                            <div class="d-flex justify-content-between">
                                                <p class="mb-2 fw-bold">Дата начала страхования:</p>
                                                <span id="effective_date_value" class="text-end"></span>
                                            </div>

                                            <div class="d-flex justify-content-between">
                                                <p class="mb-2 fw-bold">Страховой период:</p>
                                                <span class="calculated-period text-end"></span>
                                            </div>
                                            <hr>
                                            <div class="fw-bold">Страхователь (Контрагент полиса)</div>
                                            <div class="d-flex justify-content-between">
                                                <p class="mb-2 fw-bold">Имя / Организация:</p>
                                                <span id="holder[name]_value" class="text-end"></span>
                                            </div>
                                            <div class="d-flex justify-content-between">
                                                <p class="mb-2 fw-bold">IDNP/IDNO:</p>
                                                <span id="holder[idnx]_value" class="text-end"></span>
                                            </div>
                                            <div class="d-flex justify-content-between">
                                                <p class="mb-2 fw-bold">Cтрана проживания                                                    :</p>
                                                <span id="residence_country_value" class="text-end"></span>
                                            </div>
                                            <div class="d-flex justify-content-between">
                                                <p class="mb-2 fw-bold">Посещаемая страна                                                    :</p>
                                                <span id="host_country_value" class="text-end"></span>
                                            </div>
                                            <template id="insured-person-row-template">
                                                <div class="d-flex justify-content-between">
                                                    <p class="mb-2 fw-bold insured-key"></p>
                                                    <span class="text-end insured-value"></span>
                                                </div>
                                            </template>
                                            <div id="insured-people-result"></div>
                                        </div>
                                    </div>
                                    <div
                                        class="p-3 border border-black d-flex justify-content-between align-items-center"
                                        style="background: #F2F2F2; color: #231F21;"
                                    >
                                        <p class="mb-0 fs-14 fw-bold">Общая стоимость:</p>
                                        <p class="mb-0 fs-26 fw-bold" id="confirm-price"></p>
                                    </div>

                                  
                                    <!-- Contact Information -->

<!--pre>
/home/carte/laravel/storage/framework/views/e7af3e5878c4ba90921bfc32a5522a06.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] =&gt; Array
        (
            [required] =&gt; 1
            [name] =&gt; billing_first_name
            [forcedLabel] =&gt; Имя
            [placeholder] =&gt; Ion
            [minlength] =&gt; 2
            [maxlength] =&gt; 40
        )

)

</pre--><div class="d-flex flex-column position-relative input-box  p-0 m-0">
  <label class="fs-14 fw-bold" for="billing-first-name-uniqid-689afc6a22c7d">
  Имя 
  
   <span style="color: #E60028">*</span>   </label>
  <input id="billing-first-name-uniqid-689afc6a22c7d" name="billing_first_name" required class="border-0" type="text" required="required" forcedLabel="Имя" placeholder="Ion" minlength="2" maxlength="40"/>
    <p></p>
</div>

<!--pre>
/home/carte/laravel/storage/framework/views/e7af3e5878c4ba90921bfc32a5522a06.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] =&gt; Array
        (
            [required] =&gt; 1
            [name] =&gt; billing_last_name
            [forcedLabel] =&gt; Фамилия
            [placeholder] =&gt; Rusu
            [minlength] =&gt; 2
            [maxlength] =&gt; 40
        )

)

</pre--><div class="d-flex flex-column position-relative input-box  p-0 m-0">
  <label class="fs-14 fw-bold" for="billing-last-name-uniqid-689afc6a22dec">
  Фамилия 
  
   <span style="color: #E60028">*</span>   </label>
  <input id="billing-last-name-uniqid-689afc6a22dec" name="billing_last_name" required class="border-0" type="text" required="required" forcedLabel="Фамилия" placeholder="Rusu" minlength="2" maxlength="40"/>
    <p></p>
</div>

<!--pre>
/home/carte/laravel/storage/framework/views/e7af3e5878c4ba90921bfc32a5522a06.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] =&gt; Array
        (
            [required] =&gt; 1
            [name] =&gt; billing_phone
            [forcedLabel] =&gt; Номер телефона
            [placeholder] =&gt; 000000000
            [minlength] =&gt; 9
            [maxlength] =&gt; 11
        )

)

</pre--><div class="d-flex flex-column position-relative input-box  p-0 m-0">
  <label class="fs-14 fw-bold" for="billing-phone-uniqid-689afc6a22f58">
  Номер телефона 
  
   <span style="color: #E60028">*</span>   </label>
  <input id="billing-phone-uniqid-689afc6a22f58" name="billing_phone" required class="border-0" type="text" required="required" forcedLabel="Номер телефона" placeholder="000000000" minlength="9" maxlength="11"/>
    <p></p>
</div>

<!--pre>
/home/carte/laravel/storage/framework/views/e7af3e5878c4ba90921bfc32a5522a06.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] =&gt; Array
        (
            [required] =&gt; 1
            [name] =&gt; billing_email
            [forcedLabel] =&gt; Электронная почта
            [placeholder] =&gt; olivia@carteverde.nldsite.com
            [pattern] =&gt; [a-zA-Z0-9._%+\-]+@[a-z0-9.\-]+\.[a-z]{2,}$
            [maxlength] =&gt; 50
        )

)

</pre--><div class="d-flex flex-column position-relative input-box  p-0 m-0">
  <label class="fs-14 fw-bold" for="billing-email-uniqid-689afc6a230b2">
  Электронная почта 
  
   <span style="color: #E60028">*</span>   </label>
  <input id="billing-email-uniqid-689afc6a230b2" name="billing_email" required class="border-0" type="text" required="required" forcedLabel="Электронная почта" placeholder="olivia@carteverde.nldsite.com" pattern="[a-zA-Z0-9._%+\-]+@[a-z0-9.\-]+\.[a-z]{2,}$" maxlength="50"/>
    <p></p>
</div>
                                    <p class="mb-0 mt-2 fs-26 fw-bold">Оплатить с помощью</p>
<div class="col-12 mb-3 d-flex flex-column align-items-center" style="gap: 10px;">
  <div class="col-12 form-check ps-0 calculator-delivery-block">
    <input
      class="form-check-input calculator-delivery-input"
      type="radio"
      value="1"
      name="payment_method_id"
      checked
      id="payment_method_id"
      >
    <label class="form-check-label px-4 py-3 calculator-delivery-label"
           for="payment_method_id">
      <img src='https://carteverde.nldsite.com/laravel/build/assets/visa-mastercard-C756L9Vo.png'
           style="width: 70px" alt="">
      <p class="mb-0 fs-16">Банковская карта (онлайн)</p>
    </label>
  </div>
</div>
                                    
                                    <div class="input-box recaptcha-box"  id="field689afc6a232e8">
  <div class="g-recaptcha" data-sitekey="6LcdPigrAAAAAEnNzYqjXS2TrQ7ewgoSoqDqQff2" data-callback="field689afc6a232e8RecaptchaCallback"></div>
  <input type="hidden" name="recaptcha" id="field689afc6a232e8-value" value="" required data-unicode-pattern=".{10,}"/>
  
  <p class="static">Пожалуйста, выполните проверку reCAPTCHA, чтобы продолжить.</p>
</div>
<script type="text/javascript">
function field689afc6a232e8RecaptchaCallback(token){
  //console.groupCollapsed('recaptcha field689afc6a232e8 callback');
  var container=document.getElementById('field689afc6a232e8'), 
    div=container.querySelector('.g-recaptcha'), 
    input=container.querySelector('input[name="recaptcha"]');
  container.classList.remove('input-error');
  input.value=token;
  
  setTimeout(function (container,div,input){
    grecaptcha.reset(div);
    container.classList.add('input-error');
    
    input.value='';
    input.dispatchEvent(new Event('change',{'bubbles':true}));
  },50000,container,div,input);

  input.dispatchEvent(new Event('change',{'bubbles':true}));
  //console.groupEnd();
}
</script><div
    class="mt-4 d-flex flex-column flex-sm-row justify-content-between final-button-block"
    style="gap: 15px;"
>
  <button type="button" class="back-step-button btn rounded rounded-5 px-5 py-3 fs-14 fw-bold text-uppercase btn-gray2">
  <span>Назад</span>
</button>  <button
  type="button"
  class="btn rounded rounded-5 px-5 py-3 fs-14 fw-bold text-uppercase text-white text-decoration-none block-submitter"
>
  <div class="spinner-border" role="status"></div>
  Подтвердить
</button></div>
                                </div>
                            </form>
                        </div>
                    </div>

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