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<?php session_start();
require_once("../patientmanager.php");
require_once("../DBManager.php");
if(isset($_POST['signup']))
{
PatientManager::transferreferal("$_GET[prescriptionid]","$_GET[patientid]","$_POST[Transfer_IPD]","$_POST[Word]","$_POST[Bed]","$_POST[Referred_To]","$_POST[Name_Hospital]","$_POST[Name_of_Consultant]","$_POST[followup]","$_POST[followup_date]","$_POST[enteredby]");
}
?>
<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1">
<link rel="stylesheet" href="https://www.w3schools.com/w3css/4/w3.css">
<title>Document</title>
</head>
<body>
<h3 align='center'>Referred To</h3>
<input type="hidden" name="Referred_To" value='on'>
<div>
<label for="item">Name of Hospital<span>*</span><input name="Name_Hospital" type="text">
</div>
<div> <label for="item">Name of Consultant<span>*</span><input name="Name_of_Consultant" type="text">
</div>
<input type="submit" name="signup" value="Submit">
</form>
</body>
</html>