<div class="modal-header">
  <h6 class="modal-title">
    {include file='__svg_icons.tpl' icon="map" class="main-icon mr10" width="24px" height="24px"}
    {__("Add New Address")}
  </h6>
  <button type="button" class="btn-close" data-bs-dismiss="modal" aria-label="Close"></button>
</div>
<form class="js_ajax-forms" data-url="users/addresses.php?do=insert">
  <div class="modal-body">
    <!-- title -->
    <div class="form-group">
      <label class="form-label">{__("Title")}</label>
      <input name="title" type="text" class="form-control">
    </div>
    <!-- title -->
    <div class="row">
      <!-- country -->
      <div class="form-group col-md-6">
        <label class="form-label">{__("Country")}</label>
        <input name="country" type="text" class="form-control">
      </div>
      <!-- country -->
      <!-- city -->
      <div class="form-group col-md-6">
        <label class="form-label">{__("City")}</label>
        <input name="city" type="text" class="form-control">
      </div>
      <!-- city -->
    </div>
    <div class="row">
      <!-- zip code -->
      <div class="form-group col-md-6">
        <label class="form-label">{__("Zip Code")}</label>
        <input name="zip_code" type="text" class="form-control">
      </div>
      <!-- zip code -->
      <!-- phone -->
      <div class="form-group col-md-6">
        <label class="form-label">{__("Phone")}</label>
        <input name="phone" type="text" class="form-control">
      </div>
      <!-- phone -->
    </div>
    <!-- address -->
    <div class="form-group">
      <label class="form-label">{__("Address")}</label>
      <textarea name="address" rows="2" dir="auto" class="form-control"></textarea>
    </div>
    <!-- address -->
    <!-- error -->
    <div class="alert alert-danger mt15 mb0 x-hidden"></div>
    <!-- error -->
  </div>
  <div class="modal-footer">
    <button type="submit" class="btn btn-primary">{__("Add")}</button>
  </div>
</form>