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Mini Shell
<!DOCTYPE html>
<html lang="en">
<!-- Mirrored from jituchauhan.com/site-templates/medical-website-template/01_orthopaedic/contact-us.html by HTTrack Website Copier/3.x [XR&CO'2014], Wed, 24 Apr 2024 10:53:13 GMT -->
<?php include 'top.php' ?>
<body>
<!-- header-wrapper -->
<?php include 'header.php' ?>
<!-- /.header-wrapper -->
<div class="page-header">
<!-- page-header -->
<div class="container">
<div class="page-section">
<div class="row">
<!-- page section -->
<div class="col-md-6 col-sm-8 col-xs-12">
<div class="page-description">
<!-- page description -->
<h1 class="page-title">Contact us</h1>
</div>
<!-- /.page description -->
</div>
<!-- /.page section -->
</div>
</div>
</div>
</div>
<div class="page-breadcrumb">
<!-- page-breadcrumb -->
<div class="container">
<div class="row">
<div class="col-md-12 col-sm-12 col-xs-12">
<ol class="breadcrumb">
<li><a href="index.php">Home</a></li>
<li class="active">Contact us</li>
</ol>
</div>
</div>
</div>
</div>
<div class="space-medium">
<div class="container">
<div class="contact-form" style="background:linear-gradient(176deg, rgb(141 221 255) 0%, rgb(12 36 60) 100%);">
<div class="row">
<div class="col-lg-offset-2 col-lg-8 col-sm-offset-2 col-sm-8 col-md-offset-2 col-md-8 col-xs-12">
<div class="section-title text-center">
<h1 style="font-weight: 600;">Contact Us</h1>
<p style="font-weight: 600;">"Thank you for reaching out to APEX Orthopedic and Eye Hospital. Our team will respond to your inquiry promptly."</p>
</div>
</div>
</div>
<form action="inquiry.php" method="post">
<div class="form-group">
<input type="text" type="name" id="name" name="name" placeholder="Name" required>
</div>
<div class="form-group">
<input type="email" id="email" name="email" placeholder="Email" required>
</div>
<div class="form-group">
<input type="tel" id="phone" name="phone" placeholder="Phone Number" required>
</div>
<div class="form-group">
<input type="date" id="adate" name="adate" placeholder="Date" required>
</div>
<div class="form-group full-width">
<textarea id="message" name="message" rows="5" required placeholder="Message"></textarea>
</div>
<center>
<div class="form-group full-width">
<input type="submit" name="submit" value="submit">
</div>
</center>
</form>
<style>
.form-group {
margin-bottom: 20px;
}
label {
display: block;
font-weight: bold;
margin-bottom: 5px;
}
input[type="text"],
input[type="email"],
input[type="tel"],
textarea,
input[type="date"] {
width: 100%;
padding: 10px;
border: 1px solid #ccc;
border-radius: 5px;
box-sizing: border-box;
}
.form-group {
width: 48%;
display: inline-block;
vertical-align: top;
}
.form-group.full-width {
width: 100%;
}
.form-group:nth-child(odd) {
margin-right: 2%;
}
input[type="submit"] {
background-color: #ffffff;
color: #000000;
border: none;
padding: 10px 20px;
border-radius: 5px;
cursor: pointer;
}
input[type="submit"]:hover {
background-color: #45a049;
}
</style>
</div>
</div>
</div>
<div class="space-medium">
<div class="container">
<div class="row">
<div class="col-lg-4 col-md-4 col-sm-4 col-xs-12">
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/4.7.0/css/font-awesome.min.css">
<div class="contact-feature"> <span class="contact-icon"> <i class="fa fa-map-marker" style="font-size:36px"></i></span>
<div class="contact-detail">
<h3 class="contact-title" style="font-weight:600;">Address</h3>
<span class="address_text">4027, 4th Floor, Palladium Mall, Yogi Chowk Ground, Chikuwadi, Nana Varachha, Surat.</span> </div>
</div>
<div class="contact-feature"> <span class="contact-icon"> <i class="fa fa-share-alt" style="font-size:36px;"></i></span>
<div class="contact-detail">
<h3 class="contact-title" style="font-weight: 600;">Social Media</h3>
<div class="contact-social">
<ul>
<li> <a href="https://www.facebook.com/people/Apex-Orthodontic-Hospital/61557742060006/" target="blank" style="color:black;"> <i class="fa fa-facebook"></i></a> </li>
<li> <a href="https://www.instagram.com/apex_orthopedic_and_eye_hospit/?fbclid=IwAR2f5FDgoKbogpUdl3tMCI09JIW2e4vUEpGqJwxquUxieTVbQrh-UNxSqyg" target="blank" style="color:black;"> <i class="fa fa-instagram"></i></a> </li>
</ul>
</div>
</div>
</div>
</div>
<div class="col-lg-8 col-md-8 col-sm-6 col-xs-12">
<div class="row">
<div class="col-md-6">
<div class="contact-feature"> <span class="contact-icon"> <i class="fa fa-phone" style="font-size:36px"></i></span>
<div class="contact-detail">
<h3 class="contact-title" style="font-weight: 600;">Contact Numbers</h3>
<span class="phone_text">+91 70739 97405 <br>
+91 63536 23129</span> </div>
</div>
<div class="contact-feature"> <span class="contact-icon"> <i class="fa fa-envelope" style="font-size:36px;"></i></span>
<div class="contact-detail">
<h3 class="contact-title" style="font-weight: 600;">Email Address</h3>
<span class="email_text">apex@gmail.com</span> </div>
</div>
</div>
<div class="col-md-6">
<div class="contact-feature"> <span class="contact-icon"> <i class="fa fa-clock-o" style="font-size:36px"></i></span>
<div class="contact-detail">
<h3 class="contact-title" style="font-weight:600;">Time</h3>
<span class="address_text">Morning: 9:30 AM To 11:30 AM,<br/>
Evening: 5:00 PM To 7:30 PM,<br/>
Sunday: 9:30 AM To 11:30 AM </span> </div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<iframe src="https://www.google.com/maps/embed?pb=!1m14!1m8!1m3!1d14877.810524939188!2d72.8858233!3d21.2138926!3m2!1i1024!2i768!4f13.1!3m3!1m2!1s0x3be04f200bd1d803%3A0xae24c248c5196989!2sAPEX%20Orthopedic%20And%20Eye%20Hospital!5e0!3m2!1sen!2sin!4v1714536798430!5m2!1sen!2sin" width="100%" height="350" style="border:0;" allowfullscreen="" loading="lazy" referrerpolicy="no-referrer-when-downgrade"></iframe>
<?php include 'footer.php' ?>
<div class="modal fade search-modal" tabindex="-1" role="dialog" style="display: none;">
<div class="modal-dialog" role="document">
<div class="modal-content">
<div class="row">
<div class="col-lg-12">
<div class="input-group">
<input type="text" class="form-control" placeholder="Search for...">
<span class="input-group-btn">
<button class="btn btn-default" type="button">Go!</button>
</span> </div>
<!-- /input-group -->
</div>
<!-- /.col-lg-6 -->
</div>
</div>
</div>
</div>
<!-- /.tiny_footer -->
<!-- back to top icon -->
<a href="#0" class="cd-top" title="Go to top">Top</a>
<!-- jQuery (necessary for Bootstrap's JavaScript plugins) -->
<script src="js/jquery.min.js"></script>
<!-- Include all compiled plugins (below), or include individual files as needed -->
<script src="js/bootstrap.min.js"></script>
<script src="js/menumaker.min.js"></script>
<script type="text/javascript" src="js/navigation.js"></script>
<script>
function initMap() {
var myLatLng = {
lat: 23.0225,
lng: 72.5714
};
var map = new google.maps.Map(document.getElementById('googleMap'), {
zoom: 4,
center: myLatLng,
scrollwheel: false,
});
var image = 'images/marker.png';
var marker = new google.maps.Marker({
position: myLatLng,
map: map,
icon: image,
title: 'Hello World!'
});
}
</script>
<script src="https://maps.googleapis.com/maps/api/js?&callback=initMap" async defer></script>
<script src="../../../../code.jquery.com/ui/1.12.1/jquery-ui.js"></script>
<script>
$(function() {
$("#datepicker").datepicker({
//showOn: "button",
//buttonImage: "images/calendar.gif",
//buttonImageOnly: true,
//buttonText: "Select date"
});
$('#ui-datepicker-div').before('<div class="default-skin"></div>');
$('#ui-datepicker-div').appendTo('.default-skin').contents();
});
</script>
<!-- Back to top script -->
<script src="js/back-to-top.js" type="text/javascript"></script>
</body>
<!-- Mirrored from jituchauhan.com/site-templates/medical-website-template/01_orthopaedic/contact-us.html by HTTrack Website Copier/3.x [XR&CO'2014], Wed, 24 Apr 2024 10:53:13 GMT -->
</html>
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