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patient-register.jsp
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patient-register.jsp
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<%@ page language="java" contentType="text/html; charset=UTF-8" pageEncoding="UTF-8"%>
<%@ page import="database.*, model.*, java.util.List" %>
<%@ page errorPage="error.jsp"%>
<!DOCTYPE html>
<html>
<head>
<link rel="stylesheet" href="css/doctor-patient.css">
</head>
<body>
<div class="container">
<h1>Sign Up</h1>
<p>Please fill in this form to create an account.</p>
<hr style="width:109%;text-align:left;margin-left:0">
<% if(request.getAttribute("error-message") != null) { %>
<div class="alert alert-danger">
<b>Error:</b> <%=(String)request.getAttribute("error-message") %>
</div>
<% } %>
<div class="row">
<div class="col-xs-12">
<form class="form-horizontal" method="POST" action="registerController.jsp">
<div class="form-group">
<label for="name" class="col-sm-2 control-label">Name</label>
<div class="col-sm-6">
<input type="text" class="form-control" name="name" id="name" placeholder="Enter Name" required>
</div>
</div>
<div class="form-group">
<label for="surname" class="col-sm-2 control-label">Surname</label>
<div class="col-sm-6">
<input type="text" class="form-control" name="surname" id="surname" placeholder="Enter Surname" required>
</div>
</div>
<div class="form-group">
<label for="ssn" class="col-sm-2 control-label">SSN</label>
<div class="col-sm-6">
<input type="text" class="form-control" name="ssn" id="ssn" placeholder="Enter SSN" required>
</div>
</div>
<div class="form-group">
<label for="email" class="col-sm-2 control-label">Email</label>
<div class="col-sm-6">
<input type="text" class="form-control" name="email" id="email" placeholder="Enter Email" required>
</div>
</div>
<div class="form-group">
<label for="username" class="col-sm-2 control-label">Username</label>
<div class="col-sm-6">
<input type="text" class="form-control" name="username" id="username" placeholder="Enter Username" required>
</div>
</div>
<div class="form-group">
<label for="psw" class="col-sm-2 control-label">Password</label>
<div class="col-sm-6">
<input type="password" class="form-control" name="password" id="password" placeholder="Enter Password" required>
</div>
</div>
<div class="form-group">
<label for="psw-confirm" class="col-sm-2 control-label">Confirm Password</label>
<div class="col-sm-6">
<input type="password" class="form-control" name="psw-confirm" id="psw-confirm" placeholder="Confirm Password" required>
</div>
</div>
<div class="form-group">
<div class="col-sm-offset-2 col-sm-10">
<button type="submit" style="width: 110%;" class="btn btn-lg btn-success"><span class="glyphicon glyphicon-ok"></span> Submit</button>
<button type="reset" style="background-color:red; width: 110%" class="btn btn-lg btn-danger"><span class="glyphicon glyphicon-remove"></span> Cancel</button>
</div>
</div>
</form>
</div>
</div>
</div>
<script src = "js/confirm.js"></script>
</body>
</html>