{"province":"<div class=\"form-group col-sm-6\"><label class=\"control-label\" for=\"province\">State \/ Province \/ Region *<\/label><input type=\"text\" name=\"province\" value=\"\" maxlength=\"50\" class=\"form-control form-required\" id=\"province\"  \/>\n<\/div>","city":"<div class=\"form-group col-sm-12\"><label class=\"control-label\" for=\"city\">City \/ Town *<\/label><input type=\"text\" name=\"city\" value=\"\" maxlength=\"50\" class=\"form-control form-required\" id=\"city\"  \/>\n<\/div>","barangay":"","building":"","house_zip":"<div class=\"form-group col-sm-10\"><label class=\"control-label\" for=\"house_no\">House \/ Building No. \/ Street Address<\/label><input type=\"text\" name=\"house_no\" value=\"\" maxlength=\"255\" class=\"form-control\" id=\"house_no\"  \/>\n<\/div><div class=\"form-group col-sm-2\"><label class=\"control-label\" for=\"zipcode\">Zip *<\/label><input type=\"text\" name=\"zipcode\" value=\"\" maxlength=\"10\" class=\"form-control form-required\" id=\"zipcode\"  \/>\n<\/div>","call_code":""}