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HTML 

              
                <div class="container">
  <section class="product">
    <div class="product__details">
      <h1 class="product__details-heading">DJI Phantom</h1>
      <span class="product__details-sub-heading">P3 Standard</span>

      <div class="product__details-image-wrapper">
        <img class="product__details-image" src="https://image.ibb.co/nFfzRK/phantom_3_standard.png" alt="">
      </div>

      <div class="product__details-basket">
        <div class="product__details-basket-item">
          <span class="product__details-basket-heading">Quantity</span>
          <div class="product__details-basket-quantity-wrapper">
            <select class="product__details-basket-quantity" name="quantity" id="quantity" data-product-quantity>
              <option value="1">1</option>
              <option value="2">2</option>
              <option value="3">3</option>
              <option value="4">4</option>
              <option value="5">5</option>
            </select>
          </div>
        </div>

        <div class="product__details-basket-item">
          <span class="product__details-basket-heading product__details-basket-heading--right">Price</span>
          <span class="product__details-basket-price" data-product-price>$386.78</span>
        </div>
      </div>
    </div>

    <form class="card-details" action="" data-form>
      <fieldset class="card-details__fieldset">
        <span class="card-details__heading">Card Type</span>

        <div class="card-details__cards" data-card-types>
          <div class="card-details__cards-item">
            <input class="card-details__card-input" type="radio" name="cardType" id="visa" data-card-type="visa" checked>
            <label class="card-details__card-label" for="visa">Visa</label>
            <img class="card-details__cards-image" src="https://svgshare.com/i/7h2.svg" alt="Visa Card" aria-hidden="true">
          </div>

          <div class="card-details__cards-item">
            <input class="card-details__card-input" type="radio" name="cardType" id="mastercard" data-card-type="mastercard">
            <label class="card-details__card-label" for="mastercard">MasterCard</label>
            <img class="card-details__cards-image" src="https://svgshare.com/i/7fu.svg" alt="MasterCard" aria-hidden="true">
          </div>

          <div class="card-details__cards-item">
            <input class="card-details__card-input" type="radio" name="cardType" id="discover" data-card-type="discover">
            <label class="card-details__card-label" for="discover">Discover</label>
            <img class="card-details__cards-image" src="https://svgshare.com/i/7hP.svg" alt="Discover Card" aria-hidden="true">
          </div>

          <div class="card-details__cards-item">
            <input class="card-details__card-input" type="radio" name="cardType" id="express" data-card-type="express">
            <label class="card-details__card-label" for="express">American Express</label>
            <img class="card-details__cards-image" src="https://svgshare.com/i/7gD.svg" alt="Amercican Express Card" aria-hidden="true">
          </div>
        </div>
      </fieldset>

      <fieldset class="card-details__fieldset">
        <span class="card-details__heading">Card Number</span>

        <div class="card-details__number">
          <div class="card-details__number-field">
            <label for="cardNumberFirstFour" class="card-details__number-label">First Four Digits</label>
            <input class="card-details__number-input" type="text" maxlength="4" name="card-number" value="0000" id="cardNumberFirstFour" data-input>
          </div>

          <div class="card-details__number-field">
            <label for="cardNumberSecondFour" class="card-details__number-label">Second Four Digits</label>
            <input class="card-details__number-input" type="text" maxlength="4" name="card-number" value="0000" id="cardNumberSecondFour" data-input>
          </div>

          <div class="card-details__number-field">
            <label for="cardNumberThirdFour" class="card-details__number-label">Third Four Digits</label>
            <input class="card-details__number-input" type="text" maxlength="4" name="card-number" value="0000" id="cardNumberThirdFour" data-input>
          </div>

          <div class="card-details__number-field">
            <label for="cardNumberFirstFour" class="card-details__number-label">Last Four Digits</label>
            <input class="card-details__number-input" type="text" maxlength="4" name="card-number" value="0000" id="cardNumberLastFour" data-input>
          </div>

          <div class="card-details__number-card">
            <img class="card-details__number-card-image" src="https://svgshare.com/i/7h2.svg" alt="Visa Card" data-card-image>
          </div>
        </div>
      </fieldset>

      <fieldset class="card-details__fieldset">
        <span class="card-details__heading" aria-hidden="true">Card Holder Name</span>
        <div class="card-details__holder">
          <label class="card-details__holder-label" for="cardHolderName">Card Holder Name</label>
          <input class="card-details__holder-input" type="text" id="cardHolderName" data-input>
        </div>
      </fieldset>

      <fieldset class="card-details__fieldset">
        <div class="card-details__expiration">
          <span class="card-details__heading" aria-hidden="true">Expiration Date</span>
          <div class="card-details__expiration-date">
            <label class="card-details__expiration-date-label" for="expirationDate">Expiration Date</label>
            <input class="card-details__expiration-date-input" type="text" maxlength="7" value="MM / YY" id="expirationDate" data-input>
          </div>
        </div>

        <div class="card-details__security">
          <span class="card-details__heading" aria-hidden="true">CVV</span>
          <div class="card-details__details__security-code">
            <label class="card-details__security-code-label" for="expirationDate">CVV</label>
            <input class="card-details__security-code-input" type="text" maxlength="3" value="000" id="expirationDate" data-input>
          </div>
        </div>
      </fieldset>

      <button class="card-details__submit" type="button" data-submit-button>Purchase</button>
    </form>
  </section>
  
  <p>Design by <a href="https://dribbble.com/AmandaLumleyx">Amanda Lumley</a> via <a href="https://dribbble.com/shots/3237318-Daily-UI-002-Credit-Card-Checkout">Dribble</a></p>
</div>
!

CSS 

              
                $navy-blue: #013552;
$rose-pink-dark: #d40b5e;
$white: #fff;
$black: #000;

@mixin input($align) {
  width: 100%;
  padding-bottom: 5px;
  background-color: transparent;
  border-top: none;
  border-right: none;
  border-bottom: 2px solid rgba($white, 0.3);
  border-left: none;
  border-radius: 0;
  color: rgba($white, 0.3);
  font-size: 1em;
  transition: all 0.25s ease-in-out;
  appearance: none;
  
  @if ($align == 'centerText') {
    text-align: center;
  }
  
  &:focus,
  &:active,
  &--valid {
    color: $rose-pink-dark;
    border-bottom: 2px solid $rose-pink-dark;
  }
}

*,
*:before,
*:after {
  box-sizing: border-box;
}

html {
  font-size: 16px;
}

body {
  background: linear-gradient(to right, #f00f55 0%,#fa0f89 100%);
  font-family: 'Trebuchet MS', Helvetica, sans-serif;
  letter-spacing: 0.03em;
  text-rendering: optimizeLegibility;
  -webkit-font-smoothing: antialiased;
}

p, a {
  color: $white;
}

img {
  display: block;
  width: 100%;
}

select,
input {
  font-family: 'Trebuchet MS', Helvetica, sans-serif;
  letter-spacing: 0.05em;
}

button {
  font-family: 'Trebuchet MS', Helvetica, sans-serif;
  letter-spacing: 0.03em;
}

.container {
  position: relative;
  height: 100%;
  display: flex;
  flex-direction: column;
  justify-content: center;
  align-items: center;
  max-width: 1200px;
  margin: 0 auto;
  padding-right: 15px;
  padding-left: 15px;
}

.product {
  width: 100%;
  max-width: 750px;
  margin-bottom: 15px;
}

.product__details {
  padding: 30px 25px;
  background-color: #012f43;
  color: $white;
}

.product__details-heading {
  margin-top: 0;
  margin-bottom: 5px;
  font-weight: bold;
}

.product__details-sub-heading {
  display: block;
  margin-bottom: 20px;
  font-size: 1.4em;
  font-weight: bold;
}

.card-details {
  position: relative;
  padding: 25px;
  background: linear-gradient(to right, $navy-blue 0%, #00324e 100%);
  color: $white;
}

.card-details__fieldset {
  margin-top: 0;
  margin-right: 0;
  margin-bottom: 30px;
  margin-left: 0;
  padding: 0;
  border: none;
}

.card-details__heading {
  display: block;
  font-size: 0.95em;
  font-weight: bold;
}

.card-details__cards {
  display: flex;
  justify-content: space-between;
  align-items: center;
  margin-top: 20px;
}

.card-details__cards-item {
  position: relative;
  width: 18%;
  max-width: 53px;
  border-radius: 5px;
  overflow: hidden;
}

.card-details__card-input {
  position: absolute;
  top: 0;
  left: 0;
  width: 100%;
  height: 100%;
  margin: 0;
  border: none;
  cursor: pointer;
  appearance: none;
  z-index: 1;
}

.card-details__card-label {
  position: absolute;
  top: 0;
  left: 0;
  width: 0;
  height: 0;
  text-indent: -9999px;
  z-index: 0;
}

.card-details__cards-image {
  border-radius: 5px;
  opacity: 0.2;
  transition: opacity 0.25s ease-in-out;
  
  .card-details__card-input:checked ~ &,
  .card-details__card-input:hover ~ &,
  .card-details__card-input:active ~ &,
  .card-details__card-input:focus ~ & {
    opacity: 1;
  }
}

.card-details__number {
  display: flex;
  justify-content: space-between;
  align-items: flex-end;
  margin-top: 15px;
}

.card-details__number-field {
  position: relative;
  width: 15%;
}

.card-details__number-card {
  width: 14%;
  margin-left: 10px;
  border-radius: 5px;
  overflow: hidden;
}

.card-details__number-label {
  position: absolute;
  top: 0;
  left: 0;
  width: 0;
  height: 0;
  text-indent: -9999px;
  clip: rect(0, 0, 0);
}

.card-details__number-input,
.card-details__expiration-date-input,
.card-details__security-code-input {
  @include input('centerText');
}

.card-details__holder {
  position: relative;
  margin-top: 10px;
}

.card-details__holder-label,
.card-details__expiration-date-label,
.card-details__security-code-label {
  position: absolute;
  top: 0;
  left: 0;
  width: 0;
  height: 0;
  text-indent: -9999px;
  clip: rect(0, 0, 0);
}

.card-details__holder-input {
  @include input(null);
}

.card-details__expiration,
.card-details__security {
  display: inline-block;
  vertical-align: middle;
}

.card-details__expiration {
  margin-right: 50px;
}

.card-details__expiration-date {
  position: relative;
  max-width: 66px;
  margin-top: 15px;
}

.card-details__details__security-code {
  position: relative;
  max-width: 29px;
  margin-top: 15px;
}

.card-details__submit {
  display: block;
  width: 100%;
  background: radial-gradient(ellipse at center, #f93090 0%, #f10052 100%);
  background-position: center;
  background-repeat: no-repeat;
  color: $white;
  border: none;
  border-radius: 0;
  padding: 16px 35px;
  font-size: 1em;
  font-weight: bold;
  text-align: center;
  cursor: pointer;
  appearance: none;
}

.product__details-basket {
  display: flex;
  justify-content: space-between;
  margin-top: 25px;
}

.product__details-basket-heading {
  display: block;
  margin-bottom: 10px;
  color: rgba($white, 0.7);
  font-size: 0.95em;
  
  &--right {
    text-align: right;
  }
}

.product__details-basket-quantity-wrapper {
  position: relative;
  background-color: #013552;
  
  &:before {
    content: '\203A';
    position: absolute;
    top: 50%;
    right: 6px;
    font-family: 'Trebuchet MS', Helvetica, sans-serif;
    color: rgba($white, 0.7);
    font-size: 1.8em;
    transform: rotate(90deg) translateY(-50%);
    transform-origin: top;
  }
}

.product__details-basket-quantity {
  display: block;
  position: relative;
  width: 100%;
  background-color: transparent;
  margin: 0;
  padding: 6px 12px;
  border: none;
  border-radius: 0;
  color: $white;
  font-size: 1em;
  appearance: none;
  z-index: 1;
}

.product__details-basket-price {
  display: block;
  color: $rose-pink-dark;
  font-size: 1.3em;
  font-weight: bold;
}

@media screen and (min-width: 40em) {
  html,
  body {
    position: relative;
    width: 100%;
    height: 100%;
  }
  
  .product__details-heading {
    font-size: 1.7em;  
  }
  
  .card-details {
    padding-right: 50px;
    padding-bottom: 35px;
    padding-left: 50px;
  }
  
  .card-details__holder {
    width: calc(80% - 10px);
  }
}

@media screen and (min-width: 47.938em) {
  .product {
    display: flex;
    justify-content: space-between;
    align-items: center;
  }
  
  .product__details {
    position: relative;
    padding-top: 40px;
    padding-bottom: 40px;
    flex: 1;
    box-shadow: 0px 0px 15px 8px rgba($black, 0.35);
    z-index: 1;
  }
  
  .product__details-sub-heading {
    margin-bottom: 60px;
  }
  
  .product__details-image-wrapper {
    position: relative;
    margin-bottom: 40%;
    padding-top: 56.25%;
  }
  
  .product__details-image {
    position: absolute;
    top: 50%;
    left: 50%;
    width: 175%;
    height: 175%;
    transform: rotate(-5deg) translate(-50%, -50%);
    transform-origin: 50%;
    z-index: 1;
  }
  
  .card-details {
    max-width: 450px;
    box-shadow: 0px 0px 15px 8px rgba($black, 0.35);
  }
  
  .card-details__submit {
    position: absolute;
    right: 20px;
    bottom: -25px;
    width: auto;
    box-shadow: 0px 0px 15px 5px rgba($black, 0.35);
  }
  
  .card-details__fieldset {
    &:last-of-type {
      margin-bottom: 0;
    }
  }
}
!

JS 

              
                function ValidationModule({ form, inputs, submit }) {
  const state = {
    form,
    inputs,
    submit
  };
  
  function focus({ target }) {
    if (target.defaultValue === target.value) {
      target.value = '';
    }
  }
  
  function blur({ target }) {
    const defaultClassName = target.className.split(' ')[0];
    
    if (target.value === '') {
      target.value = target.defaultValue;
      target.className = defaultClassName;
      return;
    }
    
    target.className = `${defaultClassName} ${defaultClassName}--valid`;
  }
  
  function delegateEvent(event) {
    if (event.target.nodeName !== 'INPUT') {
      return;
    }
    
    if (event.type === 'focus') {
      return focus(event);
    }
    
    if (event.type === 'blur') {
      return blur(event);
    }
  }

  function bindEvents() {
    form.addEventListener('focus', delegateEvent, true);
    form.addEventListener('blur', delegateEvent, true);
  }

  return {
    bindEvents
  }
}



function checkoutForm() {
  const form = document.querySelector('[data-form]');
  const quantity = document.querySelector('[data-product-quantity]');
  const cardTypes = form.querySelector('[data-card-types]');
  const data = {
    form,
    inputs: form.querySelectorAll('[data-input]'),
    submit: form.querySelector('[data-submit]')
  };
  
  function togglePriceChange({ target }) {
    const value = parseInt(target.value, 10);
    const initialPrice = 386.78;
    const price = document.querySelector('[data-product-price]');
    const newPrice = initialPrice * value;
    
    price.textContent = `$${newPrice.toFixed(2)}`;
  }

  function toggleCardType({ target }) {
    const cardImage = form.querySelector('[data-card-image]');
    const cardTypeValue = target.getAttribute('data-card-type');
    const cardPath = 'https://svgshare.com/i/';
    const cardTypeData = {
      visa: { src: `${cardPath}7h2.svg`, alt: 'Visa Card' },
      mastercard: { src: `${cardPath}7fu.svg`, alt: 'MasterCard' },
      discover: { src: `${cardPath}7hP.svg`, alt: 'Discover Card' },
      express: { src: `${cardPath}7gD.svg`, alt: 'American Express Card' }
    }
    
    if (cardTypeData.hasOwnProperty(cardTypeValue)) {
      const data = Object.getOwnPropertyDescriptor(cardTypeData, cardTypeValue);
      
      cardImage.src = data.value.src;
      cardImage.alt = data.value.alt;
    }
  }

  function init() {
    const validation = new ValidationModule(data);
    
    quantity.addEventListener('change', togglePriceChange);
    cardTypes.addEventListener('click', toggleCardType);
    validation.bindEvents();
  }

  init();
}

checkoutForm();
!
999px

Console