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<?php session_start(); include("dbconnection.php"); require_once("../patientmanager.php"); require_once("../DBManager.php"); if(isset($_POST[Laboratoryspecimenrelatedva])) { PatientManager::Laboratoryspecimenrelated("$_GET[prescriptionid]","$_GET[patientid]","$_POST[Laboratoryspecimenrelated]","$_POST[Laboratoryspecimenrelated_Native]","$_POST[Laboratoryspecimenrelated_Corrective]","$_POST[entered_by]"); } ?> <!DOCTYPE html> <html lang="en"> <head> <meta charset="utf-8"> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <meta name="description" content=""> <meta name="author" content="Dashboard"> <meta name="keyword" content="Dashboard, Bootstrap, Admin, Template, Theme, Responsive, Fluid, Retina"> <title>Laboratory specimen related</title> <body> <h3><i class="fa fa-angle-right"></i> Laboratory specimen related </h3> <form name="Laboratoryspecimenrelatedva" method="post"> <label for="address">Laboratory specimen related</label> <select name="Laboratoryspecimenrelated"> <option value="" disabled selected>Laboratory specimen related</option> <option value="Incorrect labelling">Incorrect labelling</option> <option value="Incorrect sample collection">Incorrect sample collection </option><option value="Sample lost">Sample lost </option> </select> <label>Native description of Occurrence</label> <input type="text" name="Laboratoryspecimenrelated_Native" placeholder="Native description of Occurrence"> <label>Corrective And Preventive Action Taken</label> <input type="text" name="Laboratoryspecimenrelated_Corrective" placeholder="Corrective And Preventive Action Taken"> <br> <br> <br> <button style="float: right;" name="Laboratoryspecimenrelatedva" type="submit"> Save</button> </form> <style> form{ margin: 20px 0; } form input, button{ padding: 5px; } table{ width: 100%; margin-bottom: 20px; border-collapse: collapse; } table, th, td{ border: 1px solid #cdcdcd; } table th, table td{ padding: 10px; text-align: left; } <style> table{ border: solid 1px gray; width: 100%; } </style> </head> <div id="container"> </div>