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<?php include('include/header.php'); if(!empty($_POST['appoint'])){ $obj->appointment(); } ?> <main id="main"> <!-- ======= Breadcrumbs ======= --> <section class="breadcrumbs"> <div class="container"> <div class="d-flex justify-content-between align-items-center"> <h2>Book Appointment</h2> <ol> <li><a href="index.php">Home</a></li> <li>Book Appointment</li> </ol> </div> </div> </section><!-- End Breadcrumbs --> <section class="inner-page"> <div class="container"> <div class="row"> <div class="col-lg-12 col-md-12 pb-3"> <div class="info"> <div class="section-title"> <h2>Book Appointment</h2> </div> <form role="form" action="" method="post" enctype="multipart/form-data"> <div class="row"> <div class="col-6 mt-3"> <label for="exampleInputEmail1" class="form-label">Pasaint Name</label> <input type="text" class="form-control" name="app_name"> </div> <div class="col-6 mt-3"> <label for="exampleInputPassword1" class="form-label">Age</label> <input type="number" class="form-control" name="app_age" id="exampleInputPassword1"> </div> <div class="col-6 mt-3"> <label for="exampleInputPassword1" class="form-label">Email Id</label> <input type="email" name="app_email" class="form-control" id="exampleInputPassword1"> </div> <div class="col-6 mt-3"> <label for="exampleInputPassword1" class="form-label">Mobile Number</label> <input type="phone" maxlength="10" minlength="10" name="app_mobile" class="form-control" id="exampleInputPassword1"> </div> <div class="col-6 mt-3"> <label for="exampleInputPassword1" class="form-label">Appointment Date</label> <input type="date" class="form-control" name="app_date" id="exampleInputPassword1"> </div> <div class="col-6 mt-3"> <label for="exampleInputPassword1" class="form-label">Select Doctor</label> <select class="form-select" name="doc_id" aria-label="Default select example"> <?php $option ="<option value=''>--Doctor--</option>"; $dep_rs= mysqli_query($obj->mysqli,"SELECT * FROM `consultant`"); while($dep_data= mysqli_fetch_assoc($dep_rs)){ $option .="<option value='$dep_data[doc_id]'>$dep_data[doc_name]</option>"; } echo($option); ?> </select> </div> <div class="col-12 mt-3"> <label for="exampleInputPassword1" class="form-label">Massage</label> <textarea class="form-control" name="app_massage"></textarea> </div> <div class="text-center mt-5"> <input type="hidden" name="appoint" value="1"> <button type="submit" class="btn">Send Message</button> </div> </div> </form> </div> </div> </div> </div> </section> </main><!-- End #main --> <?php include('include/footer.php'); ?>
| ver. 1.4 |
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| PHP 7.4.33 | Генерация страницы: 0.06 |
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