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contact.php
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contact.php
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<?php
include_once('hms/include/config.php');
if(isset($_POST['submit']))
{
$name=$_POST['fullname'];
$email=$_POST['emailid'];
$mobileno=$_POST['mobileno'];
$dscrption=$_POST['description'];
$query=mysqli_query($con,"insert into tblcontactus(fullname,email,contactno,message) value('$name','$email','$mobileno','$dscrption')");
echo "<script>alert('Your information succesfully submitted');</script>";
echo "<script>window.location.href ='contact.php'</script>";
}
?>
<!DOCTYPE HTML>
<html lang="en">
<head>
<title>Medview+ - Contact us</title>
<link href="css/style.css" rel="stylesheet" type="text/css" media="all" />
<link href='http://fonts.googleapis.com/css?family=Ropa+Sans' rel='stylesheet' type='text/css'>
</head>
<body>
<!--start-wrap-->
<!--start-header-->
<div class="header">
<div class="wrap">
<!--start-logo-->
<div class="logo">
<a href="index.html" style="font-size: 30px;"><img src="images/logo.png" alt="Medview+"></a>
</div>
<!--end-logo-->
<!--start-top-nav-->
<div class="top-nav">
<ul>
<li><a href="index.html">Home</a></li>
<li class="active"><a href="contact.php">contact</a></li>
</ul>
</div>
<div class="clear"> </div>
<!--end-top-nav-->
</div>
<!--end-header-->
</div>
<div class="clear"> </div>
<div class="wrap">
<div class="contact">
<div class="section group">
<div class="col span_1_of_3">
<div class="company_address">
<h2>Hospital Address :</h2>
<p>15 Mayor Street Upper,</p>
<p>Dublin city,</p>
<p>Ireland</p>
<p>Phone: +353 (0)86 553 2019</p>
<p>Fax: +353 (0)86 553 2020</p>
<p>Email: <span>[email protected]</span></p>
</div>
</div>
<div class="col span_2_of_3">
<div class="contact-form">
<h2>Contact Us</h2>
<form name="contactus" method="post">
<div>
<span><label>NAME</label></span>
<span><input type="text" name="fullname" required="true" value=""></span>
</div>
<div>
<span><label>E-MAIL</label></span>
<span><input type="email" name="emailid" required="ture" value=""></span>
</div>
<div>
<span><label>MOBILE.NO</label></span>
<span><input type="text" name="mobileno" required="true" value=""></span>
</div>
<div>
<span><label>Description</label></span>
<span><textarea name="description" required="true"> </textarea></span>
</div>
<div>
<span><input type="submit" name="submit" value="Submit"></span>
</div>
</form>
</div>
</div>
</div>
<div class="clear"> </div>
</div>
<div class="clear"> </div>
</div>
<div class="clear"> </div>
<div class="footer">
<div class="wrap">
<div class="footer-left">
<ul>
<li><a href="index.html">Home</a></li>
<li><a href="contact.php">contact</a></li>
</ul>
</div>
<div class="clear"> </div>
</div>
</div>
<!--end-wrap-->
</body>
</html>