Mr.Fn4ticHz Shell

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PHP Version : 7.2.34
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Directory : /home/btiyawmy/public_html/login.easenup.in/FO/Patient/

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Current File : /home/btiyawmy/public_html/login.easenup.in/FO/Patient/Follow_up.php

<?php 
if(isset($_POST['sanjeeva'])) 
{
   PatientManager::followupd("$_GET[prescriptionid]","$_GET[patientid]","$_POST[Food_Intake]","$_POST[Kindly_Avoid]","$_POST[Kindly_Follow]","$_POST[Follow_Visit]","$_POST[entered_by]");
}
?>


    <form method="post" >
               <h2 align="center">Follow up</h2>
    
            
      <table id="dynamic-table" class="table table-striped table-bordered table-hover dataTable no-footer">
          <tr><td><span style="font-size: 20px">Food Intake </span></h3></td><td ><textarea name="Food_Intake" class='form-control' >
</textarea>
</td>
</tr>
<tr><td > <span style="font-size: 20px">Kindly Avoid </span></h3></td><td ><textarea name="Kindly_Avoid" class='form-control'>
</textarea>
</td>
</tr> 
<tr><td ><span style="font-size: 20px">Kindly Follow </span></h3></td ><td><textarea name="Kindly_Follow" class='form-control'>
</textarea>
</td>



</tr> 


             <tr>
                 <td ><span style="font-size: 20px">Follow up Visit : </span></td><td ><input type='date' name='Follow_Visit'></td>
             </tr>
             <tr><td colspan='2'><input type="submit" name="sanjeeva" value="Save" class='btn btn-success'></td></tr>
        </table>


</form>

Anon7 - 2022
AnonSec Team