DEWATA [ login.easenup.in ]

Name	Size	Permission
assets	[ DIR ]	drwxr-xr-x
Searchby.php	1.53 KB	-rw-r--r--
dash.php	5.02 KB	-rw-r--r--
dbconnection.php	307 B	-rw-r--r--
error_log	73.36 KB	-rw-r--r--
index.php	2.35 KB	-rw-r--r--
logout.php	210 B	-rw-r--r--
menufinal.php	2.18 KB	-rw-r--r--
newregi.php	3.09 KB	-rw-r--r--

Code Editor : newregi.php

<?php session_start();
require_once('dbconnection.php');

//Code for Registration 
if(isset($_POST['signup']))
{
  $Healthcare_provider=$_POST['Healthcare_provider'];
	$Profile=$_POST['Profile'];
	$Messages=$_POST['Messages'];
	$Timeline=$_POST['Timeline'];
	$Allergies=$_POST['Allergies'];
  $Immunization=$_POST['Immunization'];
  $Problems=$_POST['Problems'];
  $Medication=$_POST['Medication'];
  $Medical=$_POST['Medical'];
	$msg=mysqli_query($con,"insert into spcmedicine(Healthcare_provider,Profile,Messages,Timeline,Allergies,Immunization,Problems,Medication,Medical) values('$Healthcare_provider','$Profile','$Messages','$Timeline','$Allergies','$Immunization','$Problems','$Medication','$Medical')");
if($msg)
{
	echo "<script>alert('Register successfully');</script>";
}
}
?>
<!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>Hospital Dashboard</title>
    <link href="assets/css/bootstrap.css" rel="stylesheet">
    <link href="assets/font-awesome/css/font-awesome.css" rel="stylesheet" />
    <link href="assets/css/style.css" rel="stylesheet">
    <link href="assets/css/style-responsive.css" rel="stylesheet">
    <link href="assets/css/new2.css" rel="stylesheet">
  </head>
<form name="signup" method="post" >
  <fieldset>
      <legend>
        <h3>Registration form </h3>
      </legend>
  <div  class="account-details">
  <div><label for="item">Healthcare_provider<span>*</span></label><input type="text" name="Healthcare_provider" placeholder="Healthcare_provider"></div>
  <div><label for="item">Patient Profile<span>*</span></label><input type="text" name="Profile" placeholder="Healthcare_provider"></div>
  <div><label for="item">Messages<span>*</span></label><input type="text" name="Messages" placeholder="Healthcare_provider"></div>
  <div><label for="item">Timeline<span>*</span></label><input type="text" name="Timeline"   placeholder="Healthcare_provider"></div>
  <div><label for="item">Allergies<span>*</span></label><input type="text" name="Allergies" placeholder="Healthcare_provider"></div>
  <div><label for="item">Immunization<span>*</span></label><input type="text" name="Immunization" placeholder="Healthcare_provider"></div>
  <div><label for="item">Allergies<span>*</span></label><input type="text" name="Allergies" placeholder="Healthcare_provider"></div>
  <div><label for="item">Problems<span>*</span></label><input type="text" name="Problems" placeholder="Healthcare_provider"></div>
  <div><label for="item">Medication<span>*</span></label><input type="text" name="Medication" placeholder="Healthcare_provider"></div>
  <div><label for="item">Medical<span>*</span></label><input type="text" name="Medical" placeholder="Healthcare_provider"></div>
    </div>
  <button type="submit" name="signup">Submit</button>

</fieldset>
  </form>
  </body>
  </html>

${this.title}

Code Editor : newregi.php