Pay Online

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  "EnableDefaultJSValidation": false,
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      "Alias": "PatientName",
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      "UpdateDateTime": "2022-05-19T09:00:33.066271",
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    {
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    {
      "Name": "reCAPTCHA v3",
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    },
    {
      "Name": "Amount Paid",
      "Alias": "AmountPaid",
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      "UpdateDateTime": "2022-05-19T09:00:33.066271",
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    {
      "Name": "Email",
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    {
      "Name": "Accept Payment",
      "Alias": "AcceptPayment",
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      "UpdateDateTime": "0001-01-01T00:00:00",
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  ],
  "PaymentAmount": 0.0,
  "ModuleItemId": 0,
  "FormType": "Generic",
  "ModuleName": "",
  "UniqueId": "c910678f-fa9c-446e-add3-8dff4c0d68e2",
  "Parent": {
    "Value": {
      "Id": 2295,
      "ModuleLayoutName": "Page Detail",
      "Enabled": true,
      "ReleaseDate": "2019-10-23T00:00:00",
      "ExpiryDate": "2099-12-12T01:00:00",
      "Weighting": 0,
      "Item_Rating": 0,
      "CodeEditor": false,
      "ExternalId": 0,
      "DisableForSiteSearch": false,
      "Author_Name": null,
      "Author_Url": null,
      "Author": 0,
      "SEOTitle": "Pay Online | Pay My Bill | Hospitals Near Me",
      "CustomProperties": "{}",
      "LastUpdatedDate": "2020-07-23T14:14:18",
      "Module_Alias": "Page",
      "Module_Id": 1522,
      "ParentName": "Patients",
      "ParentUrl": "/patients",
      "Name": "Pay Online",
      "UrlSlug": "pay-online",
      "Url": "/patients/pay-online",
      "MetaDescription": "Fill out an online payment form by entering the amount you wish to pay, your hospital number, and the patient name.",
      "ShowPageForSearchEngine": true,
      "CanonicalLink": null,
      "MetaTitle": "Pay Online | Pay My Bill | Hospitals Near Me",
      "ParentId": 2293,
      "Url_List": [
        "/patients/pay-online"
      ],
      "ParentId_List": [
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      "EnableAMP": false,
      "AMPContent": null,
      "SocialMetaTags": null,
      "OpenGraphPropertiesValue": "{\"title\":\"\",\"type\":\"\",\"url\":\"\",\"locale\":\"\",\"image\":\"\"}",
      "SeoPriority": 0.5,
      "Description": "\n\n
\n    
\n        
Online Payment
\n        
Enter the amount you wish to pay, your hospital number, and the patient name.
\n    
\n\n
\n    {% component type: \"form\", alias: \"online_payment_form\" %}\n    \n    \n
\n
",
      "TemplateName": null,
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      "ItemTags": null,
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      "Params": {}
    },
    "Type": 5
  },
  "ReCaptcha_Sitekey": "6Ld5QIoUAAAAAKznGOlK7z6mgqJ8ajRUc3CK5M17",
  "Params": {
    "type": "form",
    "alias": "online_payment_form"
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}