Checkout Form Component

<div class="min-h-screen bg-gray-100 dark:bg-gray-900 p-6">
  <div class="max-w-md mx-auto bg-white dark:bg-gray-800 rounded-lg shadow-md overflow-hidden">
    <div class="p-6">
      <h2 class="text-2xl font-bold text-gray-800 dark:text-white mb-6">Checkout</h2>
      <form>
        <div class="mb-4">
          <label for="name" class="block text-gray-700 dark:text-gray-300 text-sm font-bold mb-2">Full Name</label>
          <input type="text" id="name" class="shadow appearance-none border rounded w-full py-2 px-3 text-gray-700 dark:text-gray-300 dark:bg-gray-700 leading-tight focus:outline-none focus:shadow-outline" placeholder="John Doe">
        </div>
        <div class="mb-4">
          <label for="email" class="block text-gray-700 dark:text-gray-300 text-sm font-bold mb-2">Email</label>
          <input type="email" id="email" class="shadow appearance-none border rounded w-full py-2 px-3 text-gray-700 dark:text-gray-300 dark:bg-gray-700 leading-tight focus:outline-none focus:shadow-outline" placeholder="[email protected]">
        </div>
        <div class="mb-4">
          <label for="address" class="block text-gray-700 dark:text-gray-300 text-sm font-bold mb-2">Address</label>
          <input type="text" id="address" class="shadow appearance-none border rounded w-full py-2 px-3 text-gray-700 dark:text-gray-300 dark:bg-gray-700 leading-tight focus:outline-none focus:shadow-outline" placeholder="123 Main St">
        </div>
        <div class="mb-4">
          <label for="city" class="block text-gray-700 dark:text-gray-300 text-sm font-bold mb-2">City</label>
          <input type="text" id="city" class="shadow appearance-none border rounded w-full py-2 px-3 text-gray-700 dark:text-gray-300 dark:bg-gray-700 leading-tight focus:outline-none focus:shadow-outline" placeholder="Anytown">
        </div>
        <div class="mb-4">
          <label for="zip" class="block text-gray-700 dark:text-gray-300 text-sm font-bold mb-2">Zip Code</label>
          <input type="text" id="zip" class="shadow appearance-none border rounded w-full py-2 px-3 text-gray-700 dark:text-gray-300 dark:bg-gray-700 leading-tight focus:outline-none focus:shadow-outline" placeholder="12345">
        </div>
        <div class="mb-6">
          <label for="card-number" class="block text-gray-700 dark:text-gray-300 text-sm font-bold mb-2">Card Number</label>
          <input type="text" id="card-number" class="shadow appearance-none border rounded w-full py-2 px-3 text-gray-700 dark:text-gray-300 dark:bg-gray-700 leading-tight focus:outline-none focus:shadow-outline" placeholder="**** **** **** ****">
        </div>
        <div class="flex items-center justify-between">
          <button type="button" class="bg-gray-600 hover:bg-gray-700 text-white font-bold py-2 px-4 rounded focus:outline-none focus:shadow-outline dark:bg-gray-700 dark:hover:bg-gray-600">
            Submit Payment
          </button>
        </div>
      </form>
    </div>
  </div>
</div>