ok
Mini Shell
<?php include ("admin/config.php");?>
<!DOCTYPE html>
<!-- MedService - Medical & Medical Health Landing Page Template design by Jthemes -->
<!--[if lt IE 7 ]><html class="ie ie6" lang="en"> <![endif]-->
<!--[if IE 7 ]><html class="ie ie7" lang="en"> <![endif]-->
<!--[if IE 8 ]><html class="ie ie8" lang="en"> <![endif]-->
<!--[if (gte IE 9)|!(IE)]><!-->
<html lang="en">
<!-- Mirrored from jthemes.net/themes/html/medservices/files/appointment.html by HTTrack Website Copier/3.x [XR&CO'2014], Tue, 31 Oct 2023 04:25:20 GMT -->
<?php include 'top.php' ?>
<body>
<!-- PAGE CONTENT
============================================= -->
<div id="page" class="page">
<?php include 'header.php' ?>
<!-- BREADCRUMB
============================================= -->
<div id="breadcrumb" class="division" style="height:300px;">
<div class="container">
<div class="row">
<div class="col">
<div class=" breadcrumb-holder">
<!-- Breadcrumb Nav -->
<nav aria-label="breadcrumb">
<ol class="breadcrumb" style="padding:63px;">
<li class="breadcrumb-item"><a href="index.php" style="color:black;">Home</a></li>
<li class="breadcrumb-item active" aria-current="page" style="color:black;">Appointment</li>
</ol>
</nav>
<!-- Title -->
<h4 class="h4-sm steelblue-color" style="color:black;">Appointment</h4>
</div>
</div>
</div> <!-- End row -->
</div> <!-- End container -->
</div> <!-- END BREADCRUMB -->
<!-- APPOINTMENT PAGE
============================================= -->
<div id="appointment-page" class="wide-60 appointment-page-section division">
<div class="container">
<div class="row">
<!-- SERVICE DETAILS -->
<div class="col-lg-8">
<div class="txt-block pr-30">
<!-- Title -->
<h3 class="h3-md steelblue-color">Book an Appointment</h3>
<!-- Text -->
<!-- APPOINTMENT FORM -->
<div id="appointment-form-holder" class="text-center">
<form action="inquiry.php" method="post">
<!-- Form Select -->
<!-- Form Select -->
<!-- Form Select -->
<!-- Contact Form Input -->
<!-- Contact Form Input -->
<div id="input-name" class="col-lg-12">
<input type="name" name="name" class="form-control name" placeholder="Enter Your Name*" required>
</div>
<br>
<div id="input-email" class="col-lg-12">
<input type="email" name="email" class="form-control email" placeholder="Enter Your Email*" required>
</div>
<br>
<div id="input-phone" class="col-lg-12">
<input type="phone" name="phone" class="form-control phone" placeholder="Enter Your Phone Number*" required>
</div>
<br>
<div id="input-date" class="col-lg-12">
<input id="datetimepicker" type="text" name="adate" class="form-control date" placeholder="Appointment Date" required>
</div>
<!-- <br>
<div id="input-department" class="col-md-12 input-department">
<select id="inlineFormCustomSelect1" name="department" class="custom-select department" required>
<option value="">Select Department</option>
<option>Pediatrics Department</option>
<option>Neurology Department</option>
<option>Haematology Department</option>
<option>X-Ray Diagnostic Department</option>
<option>Cardiology Department</option>
<option>MRI Department</option>
<option>Laboratory Services</option>
<option>Other</option>
</select>
</div> -->
<br>
<div id="input-message" class="col-lg-12 input-message">
<textarea class="form-control message" name="message" type="message" rows="6" placeholder="Your Message ..."></textarea>
</div>
<br>
<!-- Contact Form Button -->
<div class="col-lg-12 form-btn">
<button type="submit" name="submit" class="btn btn-blue blue-hover submit">Request an Appointment</button>
</div>
<!-- Contact Form Message -->
<div class="col-lg-12 appointment-form-msg text-center">
<div class="sending-msg"><span class="loading"></span></div>
</div>
</form>
</div> <!-- END APPOINTMENT FORM -->
<!-- Text -->
</div>
</div> <!-- END SERVICE DETAILS -->
<!-- SIDEBAR -->
<aside id="sidebar" class="col-lg-4">
<!-- TEXT WIDGET -->
<!-- SIDEBAR TABLE -->
<div class="sidebar-table blue-table sidebar-div mb-50">
<!-- Title -->
<h5 class="h5-md">Working Time:</h5>
<!-- Text -->
<center><h6 style="color:white;"></h6></center>
<!-- Table -->
<table class="table">
<tbody>
<tr>
<td>Mon-Sat</td>
<td> - </td>
<td class="text-right">Open 24 hours</td>
</tr>
</tbody>
</table>
<!-- Title -->
<h5 class="h5-xs">Need a personal health plan?</h5>
<!-- Text -->
<p class="p-sm">A personal health plan related to hospital care typically involves a detailed outline of an individual's healthcare needs, goals, and strategies to maintain or improve their health while receiving hospital-based treatment. </p>
</div> <!-- END SIDEBAR TABLE -->
</aside> <!-- END SIDEBAR -->
</div> <!-- End row -->
</div> <!-- End container -->
</div> <!-- END APPOINTMENT PAGE -->
<?php include 'f.php' ?>
</div> <!-- END PAGE CONTENT -->
<?php include 'wh.php' ?>
<!-- EXTERNAL SCRIPTS
============================================= -->
<script src="js/jquery-3.3.1.min.js"></script>
<script src="js/bootstrap.min.js"></script>
<script src="js/modernizr.custom.js"></script>
<script src="js/jquery.easing.js"></script>
<script src="js/jquery.appear.js"></script>
<script src="js/jquery.stellar.min.js"></script>
<script src="js/menu.js"></script>
<script src="js/sticky.js"></script>
<script src="js/jquery.scrollto.js"></script>
<script src="js/materialize.js"></script>
<script src="js/owl.carousel.min.js"></script>
<script src="js/jquery.magnific-popup.min.js"></script>
<script src="js/imagesloaded.pkgd.min.js"></script>
<script src="js/isotope.pkgd.min.js"></script>
<script src="js/hero-form.js"></script>
<script src="js/contact-form.js"></script>
<script src="js/comment-form.js"></script>
<script src="js/appointment-form.js"></script>
<script src="js/jquery.datetimepicker.full.js"></script>
<script src="js/jquery.validate.min.js"></script>
<script src="js/jquery.ajaxchimp.min.js"></script>
<script src="js/wow.js"></script>
<!-- Custom Script -->
<script src="js/custom.js"></script>
<script>
new WOW().init();
</script>
<!-- HTML5 shim, for IE6-8 support of HTML5 elements. All other JS at the end of file. -->
<!-- [if lt IE 9]>
<script src="js/html5shiv.js" type="text/javascript"></script>
<script src="js/respond.min.js" type="text/javascript"></script>
<![endif] -->
<!-- Google Analytics: Change UA-XXXXX-X to be your site's ID. Go to http://www.google.com/analytics/ for more information. -->
<!--
<script>
window.ga=window.ga||function(){(ga.q=ga.q||[]).push(arguments)};ga.l=+new Date;
ga('create', 'UA-XXXXX-Y', 'auto');
ga('send', 'pageview');
</script>
<script async src='https://www.google-analytics.com/analytics.js'></script>
-->
<!-- End Google Analytics -->
<script src="js/changer.js"></script>
<script defer src="js/styleswitch.js"></script>
</body>
<!-- Mirrored from jthemes.net/themes/html/medservices/files/appointment.html by HTTrack Website Copier/3.x [XR&CO'2014], Tue, 31 Oct 2023 04:25:20 GMT -->
</html>
Zerion Mini Shell 1.0