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Mini Shell
<!DOCTYPE html>
<html>
<!-- Mirrored from fatiherim.com/physiotherapypro/appointment.html by HTTrack Website Copier/3.x [XR&CO'2014], Mon, 08 Jan 2024 04:55:04 GMT -->
<?php include 'top.php' ?>
<body>
<?php include 'header.php' ?>
<section id="section-title" class="bg-alternative">
<div id="top-img-bg">
<h1 class="text-center">Appointment</h1>
</div>
</section>
<section id="appointment">
<div class="container">
<div class="row">
<div class="col-xs-12">
<h1 class="text-center">Make An Appointment</h1>
<div class="vs-35">
</div>
<p class="text-center">"Schedule your appointment effortlessly for personalized care and attention to your well-being."</p>
</div>
</div>
<div class="vs-35"> </div>
<div class="row">
<div class="col-xs-12 col-sm-6">
<img class="img-responsive" src="assets/img/blog/ap.jpg" />
</div>
<div class="col-xs-12 col-sm-6">
<form method="post" action="inquiry.php" class="default-form">
<div class="row clearfix">
<div class="form-group col-md-6 col-sm-12 col-xs-12">
<input type="text" name="name" value placeholder="Your Name" required>
</div>
<div class="form-group col-md-6 col-sm-12 col-xs-12">
<input type="email" name="email" value placeholder="Your Email" required>
</div>
<div class="form-group col-md-12 col-sm-12 col-xs-12">
<input type="text" name="phone" value placeholder="Your Phone Number" required>
</div>
<div class="form-group col-md-12 col-sm-12 col-xs-12">
<input type="text" name="message" value placeholder="your message" required>
</div>
<div class="form-group col-md-12 col-sm-12 col-xs-12">
<input type="text" name="adate" id="datepicker" value placeholder="Available Date" required>
</div>
<div class="form-group padd-top-10 col-md-12 col-sm-12 col-xs-12">
<button type="submit" name="submit" class="btn btn-normal pull-right">Submit</button>
</div>
</div>
</form>
</div>
</div>
</div>
</section>
<br/>
<?php include 'footer.php' ?>
<section id="go-back-top">
<a class="scroll" href="#main-menu">
<i class="fa fa-angle-up"></i>
</a>
</section>
<script data-cfasync="false" src="../cdn-cgi/scripts/5c5dd728/cloudflare-static/email-decode.min.js"></script><script src="../../ajax.googleapis.com/ajax/libs/jquery/1.12.4/jquery.min.js"></script>
<script src="../../maxcdn.bootstrapcdn.com/bootstrap/3.3.7/js/bootstrap.min.js" integrity="sha384-Tc5IQib027qvyjSMfHjOMaLkfuWVxZxUPnCJA7l2mCWNIpG9mGCD8wGNIcPD7Txa" crossorigin="anonymous"></script>
<script src="assets/js/external/jquery.backstretch.min.js"></script>
<script src="assets/js/external/jquery.countTo.js"></script>
<script src="assets/js/external/jquery.easing.1.3.js"></script>
<script src="assets/js/external/jquery.mb.YTPlayer.js"></script>
<script src="assets/js/external/waypoints.min.js"></script>
<script src="assets/js/external/jquery.bxslider.min.js"></script>
<script src="assets/js/external/slick.min.js"></script>
<script src="../../code.jquery.com/ui/1.12.1/jquery-ui.js"></script>
<script src="assets/js/external/lightbox-2.6.min.js"></script>
<script src="assets/js/external/jquery.flexslider-min.js"></script>
<script src="assets/js/project/script.js"></script>
<script>
$('.basic-carousel').flexslider({
animation: "slide",
animationLoop: false,
itemWidth: 210,
itemMargin: 5
});
</script>
</body>
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</html>
Zerion Mini Shell 1.0