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Upload File : |
<?php session_start();
require_once("../DBManager.php");
require_once("../LoginManager.php");
include 'header.php';
include 'menur.php';
$target_dir = "uploads/";
$filename = basename($_FILES["myfile"]["name"]);
$target_file = $target_dir . basename($_FILES["myfile"]["name"]);
$uploadOk = 1;
$imageFileType = strtolower(pathinfo($target_file,PATHINFO_EXTENSION));
if(isset($_POST['signup']))
{
LoginManager::registerlabdig("$_POST[hsname]","$_POST[Name]","$_POST[SPOCDESIGNATION]","$_POST[EmailID]","$_POST[numbers]","$_POST[Selectstate]","$_POST[Selectdistrict]","$_POST[Pincode]","$_POST[sanctionedbed]","$_POST[Hospitalparenttype]","$_POST[Hospitaltype]","$_POST[Registrationnumber]","$_POST[Authorityregistered]","$_POST[Organizationtype]","$filename","$_POST[ipdacs]","$_POST[entered_by]");
if (move_uploaded_file($_FILES["myfile"]["tmp_name"], $target_file)) {
echo "The file ". basename( $_FILES["myfile"]["name"]). " has been uploaded.";
} else {
echo "Sorry, there was an error uploading your file.";
}
}
?>
<!DOCTYPE html>
<html lang="en">
<head>
<script>
<script src="https://code.jquery.com/jquery-2.1.1.min.js" type="text/javascript"></script>
<script>
function checkAvailability() {
$("#loaderIcon").show();
jQuery.ajax({
url: "labdig.php",
data:'uname='+$("#EmailID").val(),
type: "POST",
success:function(data){
$("#user-availability-status").html(data);
$("#loaderIcon").hide();
},
error:function (){}
});
}
</script>
<script>
function isNumber(evt) {
evt = (evt) ? evt : window.event;
var charCode = (evt.which) ? evt.which : evt.keyCode;
if (charCode > 31 && (charCode < 48 || charCode > 57)) {
alert("Please enter only Numbers.");
return false;
}
return true;
}
function ValidateNo() {
var phoneNo = document.getElementById('numbers');
if (phoneNo.value == "" || phoneNo.value == null) {
alert("Please enter your Mobile No.");
return false;
}
if (phoneNo.value.length < 10 || phoneNo.value.length > 10) {
alert("Mobile No. is not valid, Please Enter 10 Digit Mobile No.");
return false;
}
return true;
}
</script>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1">
<title>Admin | Dashboard</title>
<script type="text/javascript">
var citiesByState = {
Bihar: ["Araria", "Arwal", "Aurangabad", "Banka", "Begusarai", "Bhagalpur", "Bhojpur", "Buxar", "Darbhanga","Gaya","Gopalganj","Jamui", "Jehanabad","Kaimur (Bhabua)","Katihar", "Khagaria","Kishanganj","khisarai" ,"Madhepura","Madhubani","Munger","Muzaffarpur","Nalanda","Nawada", "Pashchim", "Champaran (West Champaran)","Patna","Purba", "Champaran (East Champaran)","Purnia","Rohtas","Saharsa","Samastipur","Saran","Sheikhpura", "Sheohar","Sitamarhi","Siwan","Supaul","Vaishali"],
Chandigarh: ["Chandigarh"],
Delhi: ["Central Delhi","North Delhi","South Delhi","East Delhi","North East Delhi", "South West Delhi","New Delhi","North West Delhi","West Delhi","Shahdara","South Eest Delhi"],
Gujarat: ["Ahmedabad","Amreli","Anand","Aravalli","Banaskantha","Bharuch","Bhavnagar","Botad","Chhota Udaipur","Dahod","Dang","Devbhoomi Dwarka","Gandhinagar","Gir Somnath","Jamnagar","Junagadh","Kutch","Kheda ","Mahisagar","Mehsana Morbi","Narmada","Navsari","Panchmahal Patan","Porbandar","Rajkot","Sabarkantha","Surat","Surendranagar","Tapi", "Vadodara","Valsad"],
Himachal: ["Bilaspur","Chamba","Hamirpur","Kangra","Kinnaur","Kullu","Lahaul & Spiti","Mandi","Shimla","Sirmaur","Solan","Una"],
Maharashtra: ["Ahmednagar","Akola","Amravati","Aurangabad","Beed","Bhandara","Buldhana","Chandrapur","Dhule","Gadchiroli","Gondia","Hingoli","Jalgaon","Jalna","Kolhapur","Latur","Mumbai City","Mumbai Suburban","Nagpur","Nanded","Nandurbar","Nashik","Osmanabad ","Palghar","Parbhani","Pune","Raigad","Ratnagiri","Sangli","Satara" ,"Sindhudurg","Solapur","Thane","Wardha","Washim","Yavatmal"],
Punjab: ["Amritsar","Barnala","Bathinda","Faridkot","Fatehgarh","Sahib","Firozpur","Fazilka","Gurdaspur","Hoshiarpur","Jalandhar","Kapurthala" ,"Ludhiana","Mansa","Moga","Sri Muktsar Sahib","Pathankot","Patiala","Rupnagar","Sahibzada","Ajit Singh Nagar","Sangrur","Shahid Bhagat Singh Nagar", "Taran Taran"],
Rajasthan: ["Ajmer","Alwar","Banswara","Baran","Barmer","Bharatpur","Bhilwara","Bikaner","Bundi","Chittorgarh","Churu","Dausa","Dholpur","Dungarpur","Hanumangarh","Jaipur","Jaisalmer","Jalor","Jhalawar" ,"Jhunjhunu","Jodhpur","Karauli","Kota","Nagaur","Pali","Pratapgarh", "Rajsamand","Sawai","Madhopur","Sikar","Sirohi","Sri Ganganagar","Tonk","Udaipur"],
Haryana: ["Ambala","Bhiwani","Charkhi","Dadri","Faridabad","Fatehabad","Gurugram","Hisar","Jhajjar","Jind","Kaithal","Karnal","Kurukshetra" ,"Mahendragarh","Nuh","Palwal","Panchkula","Panipat","Rewari","Rohtak","Sirsa","Sonipat","Yamunanagar"],
UttarPradesh : ["Agra","Aligarh","Allahabad","Ambedkar Nagar","Amethi (Chatrapati Sahuji Mahraj Nagar)", "Amroha (J.P. Nagar)","Auraiya", "Azamgarh", "Baghpat", "Bahraich", "Ballia", "Balrampur", "Banda", "Barabanki", "Bareilly", "Basti", "Bhadohi", "Bijnor", "Budaun", "Bulandshahr", "Chandauli", "Chitrakoot", "Deoria", "Etah", "Etawah", "Faizabad", "Farrukhabad", "Fatehpur", "Firozabad", "Gautam Buddha Nagar", "Ghaziabad", "Ghazipur", "Gonda", "Gorakhpur", "Hamirpur", "Hapur", "(Panchsheel Nagar) Hardoi", "Hathras","Jalaun", "Jaunpur", "Jhansi", "Kannauj", "Kanpur", "Dehat", "Kanpur Nagar", "Kanshiram Nagar(Kasganj)", "Kaushambi", "Kushinagar (Padrauna)", "Lakhimpur - Kheri", "Lalitpur","Lucknow","Maharajganj", "Mahoba", "Mainpuri", "Mathura", "Mau", "Meerut", "Mirzapur", "Moradabad", "Muzaffarnagar", "Pilibhit", "Prayagraj", "Pratapgarh", "RaeBareli", "Rampur","Saharanpur", "Sambhal (Bhim Nagar)", "Sant Kabir Nagar", "Shahjahanpur", "Shamali (Prabuddh Nagar)", "Shravasti", "Siddharth Nagar", "Sitapur", "Sonbhadra", "Sultanpur", "Unnao", "Varanasi" ],
Uttarakhand: ["Almora","Bageshwar","Chamoli","Champawat","Dehradun", "Haridwar","Nainital", "Pauri","Pithoragarh", "Rudraprayag","Tehri","Udham Singh Nagar","Uttarkashi"]
}
function makeSubmenu(value) {
if(value.length==0) document.getElementById("citySelect").innerHTML = "<option></option>";
else {
var citiesOptions = "";
for(cityId in citiesByState[value]) {
citiesOptions+="<option>"+citiesByState[value][cityId]+"</option>";
}
document.getElementById("citySelect").innerHTML = citiesOptions;
}
}
function displaySelected() { var country = document.getElementById("countrySelect").value;
var city = document.getElementById("citySelect").value;
alert(country+"\n"+city);
}
function resetSelection() {
document.getElementById("countrySelect").selectedIndex = 0;
document.getElementById("citySelect").selectedIndex = 0;
}
</script>
</head>
<body>
<div class="content-wrapper">
<!-- Content Header (Page header) -->
<section class="content-header">
<h3><i class="fa fa-angle-right"></i> Registration Form </h3>
<form method="post" name="signup" enctype="multipart/form-data">
<div class="account-details">
<div> <label for="item">Name of Organization<span>*</span></label>
<input type="text" name="hsname" id="hsname" required></div>
<div>
<label for="address">SPOC NAME<span>*</span></label>
<input id="address" type="text" id="Name" name="Name" required>
</div>
<div>
<label for="address">SPOC DESIGNATION<span>*</span></label>
<input type="text" name="SPOCDESIGNATION" id="SPOCDESIGNATION" required>
</div>
<div id="frmCheckUsername">
<label for="address">Email ID<span>*</span></label>
<input type="email" name="EmailID" id="EmailID" id="EmailID" class="demoInputBox" onBlur="checkAvailability()" required>
<span id="user-availability-status"></span>
</div>
<p><img src="LoaderIcon.gif" id="loaderIcon" style="display:none" />
<div>
<label for="address">Mobile number<span>*</span></label>
<input type="text" onkeypress="return isNumber(event)" name="numbers" id="numbers" required>
</div>
<div>
<label for="address">Select state<span>*</span></label>
<select onclick="ValidateNo();" size="1" onchange="makeSubmenu(this.value)" name="Selectstate"required>
<option value="" disabled selected>Select state</option>
<option>Bihar</option>
<option value='Chandigarh'>Chandigarh</option>
<option value='Delhi'>Delhi</option>
<option value='Gujarat'>Gujarat</option>
<option value='Haryana'>Haryana</option>
<option value='Himachal'>Himachal Pradesh</option>
<option value='Maharashtra'>Maharashtra</option>
<option value='Punjab'>Punjab</option>
<option value='Rajasthan'>Rajasthan</option>
<option>UttarPradesh</option>
<option>Uttarakhand</option>
</select>
</div>
<div>
<label for="address">Select district<span>*</span></label>
<select onclick="ValidateNo();" id="citySelect" size="1" name="Selectdistrict" required>
<option value="" disabled selected>Select district</option>
</select>
</div>
<div>
<label for="address">Pin code<span>*</span></label>
<input type="text" name="Pincode" id="Pincode" onclick="ValidateNo();" required>
</div>
<div>
<label for="address">Organizational parent type<span>*</span></label>
<select onclick="ValidateNo();" id="Hospitalparenttype" name="Hospitalparenttype" required>
<option value="" disabled selected>Organizational parent type </option>
<option value="Single">Single</option>
<option value="Group">Group</option>
</select>
</div>
<div>
<label for="address">Ownership Type <span>*</span></label>
<select id="Hospitaltype" name="Hospitaltype" required>
<option value="" disabled selected>Ownership Type </option>
<option value="1">Public/private(corporate)</option>
<option value="2">Government</option>
<option value="3">Trust/charitable</option>
<option value="4">Other</option>
</select>
</div>
<div>
<label for="address">Registration number <span>*</span></label>
<input type="text" id="Registrationnumber" name="Registrationnumber"/ required>
</div>
<div>
<label for="address">Registered Under Authority </label>
<select id="Authorityregistered" name="Authorityregistered">
<option value="" disabled selected>Registered Under </option>
<option value="CMO/Local Authority">CMO/Local Authority</option>
</select>
</div></div>
<label for="address">Upload Certificate </label>
<input type="file" id="myfile" name="myfile">
<br><br>
<input type="submit" name="signup" id="signup" value="Submit" >
</p>
</div>
</div>
</div>
</div>
<div class="clear"></div>
</div>
</div>
</section>
</form>
<script type="application/javascript">
var alphaExp = /^[a-zA-Z]+$/; //Variable to valusernoate only alphabets
var alphaspaceExp = /^[a-zA-Z\s]+$/; //Variable to valusernoate only alphabets and space
var numericExpression = /^[0-9]+$/; //Variable to valusernoate only numbers
var alphanumericExp = /^[0-9a-zA-Z]+$/; //Variable to valusernoate numbers and alphabets
var emailidExp = /^[\w\-\.\+]+\@[a-zA-Z0-9\.\-]+\.[a-zA-z0-9]{2,4}$/; //Variable to valusernoate emailid userno
function valusernoateform()
{
if(document.frmsite_users.site_usersname.value == "")
{
alert("site_users name should not be empty..");
document.frmsite_users.site_usersname.focus();
return false;
}
else if(!document.frmsite_users.site_usersname.value.match(alphaspaceExp))
{
alert("site_users name not valuserno..");
document.frmsite_users.site_usersname.focus();
return false;
}
else if(document.frmsite_users.loginuserno.value == "")
{
alert("Login userno should not be empty..");
document.frmsite_users.loginuserno.focus();
return false;
}
else if(!document.frmsite_users.loginuserno.value.match(alphanumericExp))
{
alert("Login userno not valuserno..");
document.frmsite_users.loginuserno.focus();
return false;
}
else if(document.frmsite_users.password.value == "")
{
alert("Password should not be empty..");
document.frmsite_users.password.focus();
return false;
}
else if(document.frmsite_users.password.value.length < 8)
{
alert("Password length should be more than 8 characters...");
document.frmsite_users.password.focus();
return false;
}
else if(document.frmsite_users.password.value != document.frmsite_users.cnfirmpassword.value )
{
alert("Password and confirm password should be equal..");
document.frmsite_users.password.focus();
return false;
}
else if(document.frmsite_users.select.value == "" )
{
alert("Kindly select the status..");
document.frmsite_users.select.focus();
return false;
}
else
{
return true;
}
}
</script>