ok
Mini Shell
<!DOCTYPE html>
<html lang="en">
<!-- Mirrored from 7oroof.com/demos/medcity/appointment.html by HTTrack Website Copier/3.x [XR&CO'2014], Tue, 27 Feb 2024 04:19:43 GMT -->
<?php include 'top.php' ?>
<body>
<div class="wrapper">
<?php include 'header.php' ?>
<!-- ========================
page title
=========================== -->
<section class="page-title page-title-layout5 bg-overlay">
<div class="bg-img"><img src="assets/images/7.jpg" alt="background"></div>
<div class="container">
<div class="row">
<div class="col-12">
<h1 class="pagetitle__heading">Appointment</h1>
<nav>
<ol class="breadcrumb mb-0">
<li class="breadcrumb-item"><a href="index.php">Home</a></li>
<li class="breadcrumb-item active" aria-current="page">Appointment</li>
</ol>
</nav>
</div><!-- /.col-12 -->
</div><!-- /.row -->
</div><!-- /.container -->
</section><!-- /.page-title -->
<br/>
<br/>
<!-- ======================
Team
========================= -->
<section class="contact-layout3 bg-overlay bg-overlay-primary-gradient pb-60">
<div class="bg-img"><img src="assets/images/banners/3.jpg" alt="banner"></div>
<div class="container">
<div class="row">
<div class="col-sm-12 col-md-12 col-lg-12">
<div class="contact-panel mb-50">
<form method="post" action="inquiry.php">
<div class="row">
<div class="col-sm-12">
<h4 class="contact-panel__title">Book An Appointment</h4>
<p class="contact-panel__desc mb-30">Please book your appointment by calling our hotline. We're available 24/7 for your convenience.
</p>
</div>
<div class="col-sm-12 col-md-12 col-lg-12">
<div class="form-group">
<i class="icon-news form-group-icon"></i>
<input type="name" class="form-control" placeholder="Name" id="contact-name" name="name"
required>
</div>
</div><!-- /.col-lg-6 -->
<div class="col-sm-12 col-md-12 col-lg-12">
<div class="form-group">
<i class="icon-email form-group-icon"></i>
<input type="email" class="form-control" placeholder="Email" id="contact-email"
name="email" required>
</div>
</div><!-- /.col-lg-6 -->
<div class="col-sm-4 col-md-4 col-lg-4">
<div class="form-group">
<i class="icon-phone form-group-icon"></i>
<input type="phone" class="form-control" placeholder="Phone" id="Phone"
name="phone" required>
</div>
</div><!-- /.col-lg-4 -->
<div class="col-sm-4 col-md-4 col-lg-4">
<div class="form-group form-group-date">
<i class="icon-calendar form-group-icon"></i>
<input type="date" class="form-control" id="contact-date" name="adate" required>
</div>
</div><!-- /.col-lg-4 -->
<div class="col-sm-4 col-md-4 col-lg-4">
<div class="form-group form-group-date">
<i class="icon-clock form-group-icon"></i>
<input type="time" class="form-control" id="contact-time" name="atime" required>
</div>
</div><!-- /.col-lg-4 -->
<div class="col-sm-12 col-md-12 col-lg-12">
<div class="form-group form-group-date">
<i class="icon-news form-group-icon"></i>
<textarea class="form-control" name="message" placeholder="Message"></textarea>
</div>
</div><!-- /.col-lg-4 -->
<div class="col-12">
<button type="Submit" name="Submit" class="btn btn__secondary btn__rounded btn__block btn__xhight mt-10">
<span>Book Appointment</span> <i class="icon-arrow-right"></i>
</button>
<div class="contact-result"></div>
</div><!-- /.col-lg-12 -->
</div><!-- /.row -->
</form>
</div>
</div><!-- /.col-lg-7 -->
</div><!-- /.row -->
</div><!-- /.container -->
</section><!-- /.contact layout 3 -->
<br/>
<!-- ========================
Footer
========================== -->
<?php include 'footer.php' ?>
<button id="scrollTopBtn"><i class="fas fa-long-arrow-alt-up"></i></button>
</div><!-- /.wrapper -->
<script src="assets/js/jquery-3.5.1.min.js"></script>
<script src="assets/js/plugins.js"></script>
<script src="assets/js/main.js"></script>
</body>
<!-- Mirrored from 7oroof.com/demos/medcity/appointment.html by HTTrack Website Copier/3.x [XR&CO'2014], Tue, 27 Feb 2024 04:19:46 GMT -->
</html>
Zerion Mini Shell 1.0