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<!DOCTYPE html> <?php include('config.php'); session_start(); $pid =$_SESSION['user_id']; $sql ="select * from patient_detail where login_id='$pid'"; $row = $conn->query($sql); $pdtl = mysqli_fetch_array($row); ?> <?php if(isset($_POST['btnsub'])) { $pid=$_POST['patient_id']; $gnd=$_POST['gender']; $mob=$_POST['mobile_number']; $date=$_POST['dob']; $add=$_POST['street_address']; $ema=$_POST['email']; $tim=$_POST['time']; $conslt=$_POST['textconsult']; $check=$_POST['test']; $chkVl=""; $slNm=$_POST['spl_name']; $docNm=$_POST['doct_name']; //echo count($check).'<br>';exit; for($i=0;$i<=count($check);$i++) { $chkVl.=$check[$i].','; } $sql1="insert into appoint_tbl(patient_id,time_slot,treatment,doct_special,doctid,status)values('$pid','$tim','$chkVl','$slNm','$docNm','1')"; $row = $conn->query($sql1); header('Location:appointment.php'); } ?> <html> <head> <meta charset="utf-8"> <meta http-equiv="X-UA-Compatible" content="IE=edge"> <meta name="viewport" content="width=device-width, initial-scale=1"> <title>Left Sidebar</title> <link rel="stylesheet" href="pt_css/assets/demo.css"> <link rel="stylesheet" href="pt_css/assets/sidebar-left.css"> <link rel="stylesheet" href="http://maxcdn.bootstrapcdn.com/font-awesome/4.2.0/css/font-awesome.min.css"> <link href='http://fonts.googleapis.com/css?family=Cookie' rel='stylesheet' type='text/css'> <script src="js/jquery-2.1.1.js"></script> <!-- stylesheets --> <link rel="stylesheet" href="pt_css/font-awesome.css"> <link rel="stylesheet" href="pt_css/style.css"> <link rel="stylesheet" href="css/default.css"> <!-- google fonts --> <link href="//fonts.googleapis.com/css?family=Roboto+Condensed:300,300i,400,400i,700,700i" rel="stylesheet"> <link href="//fonts.googleapis.com/css?family=Josefin+Sans:300,400,400i,700" rel="stylesheet"> </head> <style> body { background-image:url('image/1.jpg'); background-size:100% 100%; } label.form-label { display: inline-block; width: 30%; font-weight: 400; letter-spacing: 1px; vertical-align: top; text-align: left; } </style> <body> <aside class="sidebar-left" style="width: 200px;"> <a class="company-logo" href="#">Logo</a> <div class="sidebar-links"> <a class="link-blue" href="javascript:patient_pg(1,<?=$pid?>);"><i class="fa fa-keyboard-o"></i>Add Appointment</a> <a class="link-red" href="viewappointment.php"><i class="fa fa-keyboard-o"></i>View Appointment</a> <a class="link-yellow selected" href="patient_profile.php"><i class="fa fa-keyboard-o"></i>View Profile</a> <a class="link-green" href="logout.php"><i class="fa fa-map-marker"></i>Logout</a> </div> </aside> <div class="w3ls-banner"> <!---728x90---> <div class="heading"> <h1>Appoint My Doctor</h1> </div> <!---728x90---> <div class="main-content"> <div class="menu"> <div id="show_login"> <div class="container" style="width: 918px; margin-top: -121px;"> <div class="heading"> <h2>Please Enter Patients Details</h2> <p>Fill the form below and submit your query we will contact you as soon as possible.</p> </div> <div class="agile-form"> <form action="" method="post"> <div class="row"> <div class="col-md-12"> <label class="form-label" style="align:left;"> Full Name <span class="form-required"> * </span> </label> <div class="form-input" style="align:left;"><?=$pdtl['user_name']?></div> </div> <br/> <div class="col-md-12"> <label class="form-label" style="align:left;"> Email <span class="form-required" > * </span> </label> <div class="form-input" style="align:left;"><?=$pdtl['email']?></div> </div> <br/> <div class="col-md-12"> <label class="form-label" style="align:left;"> DOB <span class="form-required"> * </span> </label> <div class="form-input" style="align:left;"><?=$pdtl['dob']?></div> </div> <br/> <div class="col-md-12"> <label class="form-label" style="align:left;"> Address <span class="form-required"> * </span> </label> <div class="form-input" style="align:left;"><?=$pdtl['street_address']?></div> </div> <br/> </form> </div> </div> </div> <!---728x90---> </div> </div> </div> <div class="copyright"> <p>© 2017 Appoint My Doctor Form. All rights reserved | Design by <a href="www.w3layouts.com">W3layouts</a></p> </div> <script src="http://ajax.googleapis.com/ajax/libs/jquery/2.1.1/jquery.min.js"></script> <script> $(function () { var links = $('.sidebar-links > a'); links.on('click', function () { links.removeClass('selected'); $(this).addClass('selected'); }) }); </script> <script> function valtimeslot(id) { var time=''; $('#show_err').load('checktime.php?id='+id+'&time='+time); } function patient_pg(page,id){ if(page==1) { $('#show_login').load('addpatient.php?id='+id);} if(page==2) { $('#show_login').load('viewappointment.php'); } if(page==3) { $('#show_login').load('viewpatient.php'); } if(page==4) { $('#show_login').load('logout.php'); } } function showdoctor(id) { $('#show_doctnm').load('show_doct.php?id='+id); } </script> </body> </html>