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Mini Shell

Direktori : /home/importfo/www/sparshphysio21.in/
Upload File :
Current File : /home/importfo/www/sparshphysio21.in/appoinment.php

<?php include("admin/config.php");?>

<!DOCTYPE html>
<html dir="ltr" lang="en">

<!-- Mirrored from kodesolution.com/html/2016/health-zone-html/demo/index-physiotherapy-mp-layout1.html by HTTrack Website Copier/3.x [XR&CO'2014], Fri, 18 Aug 2023 06:32:08 GMT -->
<?php include 'top.php' ?>
<body class="">
<div id="wrapper">
  <!-- preloader -->
  
  
  
 <?php include 'header.php' ?>
  <!-- Start main-content -->
  <div class="main-content">

    <!-- Section: inner-header -->
   <section class="inner-header divider" data-parallax-ratio="0.7" data-bg-img="images/p1.png">
      <div class="container pt-100 pb-50">
        <!-- Section Content -->
        <div class="section-content pt">
          <div class="row">
            <div class="col-md-12">
              <h3 class="title text-white">About</h3>
            </div>
          </div>
        </div>
      </div>
    </section>

    <section>
      <div class="container">
        <div class="row">
          <div class="col-md-6 col-md-push-3">
            <div class="border-1px p-25">
              <h4 class="text-theme-colored text-uppercase m-0">Make an Appointment</h4>
              <div class="line-bottom mb-30"></div>
              <p>Lorem ipsum dolor sit amet, consectetur elit.</p>
              <form action="inquiry.php" method="post">
                <div class="row">
                  <div class="col-sm-12">
                  <div>
    <input type="text" class="form-control" name="name" placeholder="Your name*">
                            </div>
<br/>
<div>
    <input type="email" class="form-control" name="email" placeholder="Your Email*">
                            </div>
                            <br/>
<div>
    <input type="contact" class="form-control" name="contact" placeholder="contact*">
                            </div>
<br/>
<div>
    <input type="time" class="form-control" name="time" placeholder="Time*">
                            </div>
<br/>
<div>
    <input type="message" class="form-control" name="message" placeholder="Message*">
                            </div>
                            <br/>
<div class="form">
<input type="submit" name="submit" required>
</div>
              </form>
              <!-- Appointment Form Validation-->
              <script type="text/javascript">
                $("#appointment_form").validate({
                  submitHandler: function(form) {
                    var form_btn = $(form).find('button[type="submit"]');
                    var form_result_div = '#form-result';
                    $(form_result_div).remove();
                    form_btn.before('<div id="form-result" class="alert alert-success" role="alert" style="display: none;"></div>');
                    var form_btn_old_msg = form_btn.html();
                    form_btn.html(form_btn.data("loading-text"));
                    $(form).ajaxSubmit({
                      target: form_result_div,
                      success: function(data) {
                        form_btn.html(form_btn_old_msg);
                        $(form).find('.form-control').val('');
                        $(form_result_div).fadeIn('slow');
                        setTimeout(function(){ $(form_result_div).fadeOut('slow') }, 6000);
                      }
                    });
                  }
                });
              </script>
            </div>
          </div>
        </div>
      </div>
    </section> 
  </div>  
  <!-- end main-content -->
  
 <?php include 'footer.php' ?>
  <a class="scrollToTop" href="#"><i class="fa fa-angle-up"></i></a>
</div>
<!-- end wrapper -->

<!-- Footer Scripts -->
<!-- JS | Custom script for all pages -->
<script src="js/custom.js"></script>

</body>

<!-- Mirrored from kodesolution.com/html/2016/health-zone-html/demo/form-appointment-style1.html by HTTrack Website Copier/3.x [XR&CO'2014], Fri, 18 Aug 2023 06:40:01 GMT -->
</html>

Zerion Mini Shell 1.0