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feedback.php
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feedback.php
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<?php
session_start();
error_reporting(E_ALL);
ini_set("display_errors", 1);
require_once('server.php');
if($_POST){
$name = $_POST['name'];
$email = $_POST['email'];
$phone = $_POST['phone'];
$service = $_POST['service'];
$rate = $_POST['to-value'];
//echo $rate;
$message = $_POST['message'];
$query="insert into feedback(name,email,phone,service,rate,message)
values('$name','$email','$phone','$service','$rate','$message')";
mysqli_query($con,$query);
echo mysqli_error($con);
}
?>
<html>
<html lang="en">
<head>
<title>Feedback-HealthCare</title>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1">
<!--===============================================================================================-->
<link rel="icon" type="image/png" href="img/icons/favicon.ico"/>
<!--===============================================================================================-->
<link rel="stylesheet" type="text/css" href="assets/vendor/bootstrap/css/bootstrap.min.css">
<!--===============================================================================================-->
<link rel="stylesheet" type="text/css" href="assets/fonts/font-awesome-4.7.0/css/font-awesome.min.css">
<!--===============================================================================================-->
<link rel="stylesheet" type="text/css" href="assets/fonts/iconic/css/material-design-iconic-font.min.css">
<!--===============================================================================================-->
<link rel="stylesheet" type="text/css" href="assets/vendor/animate/animate.css">
<!--===============================================================================================-->
<link rel="stylesheet" type="text/css" href="assets/vendor/css-hamburgers/hamburgers.min.css">
<!--===============================================================================================-->
<link rel="stylesheet" type="text/css" href="assets/vendor/animsition/css/animsition.min.css">
<!--===============================================================================================-->
<link rel="stylesheet" type="text/css" href="assets/vendor/select2/select2.min.css">
<!--===============================================================================================-->
<link rel="stylesheet" type="text/css" href="assets/vendor/daterangepicker/daterangepicker.css">
<!--===============================================================================================-->
<link rel="stylesheet" type="text/css" href="assets/vendor/noui/nouislider.min.css">
<!--===============================================================================================-->
<link rel="stylesheet" type="text/css" href="css/util.css">
<link rel="stylesheet" type="text/css" href="css/main.css">
<!--===============================================================================================-->
</head>
<body>
<div class="container-contact100">
<div class="wrap-contact100">
<form class="contact100-form validate-form" method="post" action="feedback.php">
<span class="contact100-form-title">
FEEDBACK
</span>
<div class="wrap-input100 validate-input bg1" data-validate="Please Type Your Name">
<span class="label-input100">FULL NAME *</span>
<input class="input100" type="text" name="name" placeholder="Enter Your Name">
</div>
<div class="wrap-input100 validate-input bg1 rs1-wrap-input100" data-validate = "Enter Your Email (e@a.x)">
<span class="label-input100">Email *</span>
<input class="input100" type="text" name="email" placeholder="Enter Your Email ">
</div>
<div class="wrap-input100 bg1 rs1-wrap-input100">
<span class="label-input100">Phone</span>
<input class="input100" type="number" name="phone" placeholder="Enter Number Phone">
</div>
<div class="wrap-input100 input100-select bg1">
<span class="label-input100">Services Used *</span>
<div>
<select class="js-select2" name="service">
<option value="hospital">Hosptial</option>
<option value="yoga">Yoga</option>
<option value="gym">GYM</option>
</select>
<div class="dropDownSelect2"></div>
</div>
</div>
<!-- <div class="w-full dis-none js-show-service">
<div class="wrap-contact100-form-radio">
<span class="label-input100">What type of products do you sell?</span>
<div class="contact100-form-radio m-t-15">
<input class="input-radio100" id="radio1" type="radio" name="type-product" value="physical" checked="checked">
<label class="label-radio100" for="radio1">
Phycical Products
</label>
</div>
<div class="contact100-form-radio">
<input class="input-radio100" id="radio2" type="radio" name="type-product" value="digital">
<label class="label-radio100" for="radio2">
Digital Products
</label>
</div>
<div class="contact100-form-radio">
<input class="input-radio100" id="radio3" type="radio" name="type-product" value="service">
<label class="label-radio100" for="radio3">
Services Consulting
</label>
</div>
</div> -->
<div class="wrap-contact100-form-range">
<span class="label-input100">Rate us *</span>
<div class="contact100-form-range-value">
<span id="value-lower">10</span> - <span id="value-upper">10</span>
<input type="text" name="from-value">
<input type="text" name="to-value">
</div>
<div class="contact100-form-range-bar">
<div id="filter-bar"></div>
</div>
<br>
<span class="label-input100">Message</span>
<textarea class="input100" name="message" placeholder="Your message here..." rows="3" cols="3"></textarea>
</div>
</div>
<!-- <div class="wrap-input100 validate-input bg0 rs1-alert-validate form-control" data-validate = "Please Type Your Message">
<span class="label-input100">Message</span>
<textarea class="input100" name="message" placeholder="Your message here..." rows="3" cols="3"></textarea>
</div> -->
<div class="container-contact100-form-btn">
<button class="contact100-form-btn">
<span>
Submit
<i class="fa fa-long-arrow-right m-l-7" aria-hidden="true"></i>
</span>
</button>
</div>
</form>
</div>
</div>
<!--===============================================================================================-->
<script src="assets/vendor/jquery/jquery-3.2.1.min.js"></script>
<!--===============================================================================================-->
<script src="assets/vendor/animsition/js/animsition.min.js"></script>
<!--===============================================================================================-->
<script src="assets/vendor/bootstrap/js/popper.js"></script>
<script src="assets/vendor/bootstrap/js/bootstrap.min.js"></script>
<!--===============================================================================================-->
<script src="assets/vendor/select2/select2.min.js"></script>
<script>
$(".js-select2").each(function(){
$(this).select2({
minimumResultsForSearch: 20,
dropdownParent: $(this).next('.dropDownSelect2')
});
$(".js-select2").each(function(){
$(this).on('select2:close', function (e){
if($(this).val() == "Please chooses") {
$('.js-show-service').slideUp();
}
else {
$('.js-show-service').slideUp();
$('.js-show-service').slideDown();
}
});
});
})
</script>
<!--===============================================================================================-->
<script src="assets/vendor/daterangepicker/moment.min.js"></script>
<script src="assets/vendor/daterangepicker/daterangepicker.js"></script>
<!--===============================================================================================-->
<script src="assets/vendor/countdowntime/countdowntime.js"></script>
<!--===============================================================================================-->
<script src="assets/vendor/noui/nouislider.min.js"></script>
<script>
var filterBar = document.getElementById('filter-bar');
noUiSlider.create(filterBar, {
start: [ 0, 5 ],
connect: true,
range: {
'min': 1,
'max': 10
}
});
var skipValues = [
document.getElementById('value-lower'),
document.getElementById('value-upper')
];
filterBar.noUiSlider.on('update', function( values, handle ) {
skipValues[handle].innerHTML = Math.round(values[handle]);
$('.contact100-form-range-value input[name="from-value"]').val($('#value-lower').html());
$('.contact100-form-range-value input[name="to-value"]').val($('#value-upper').html());
});
</script>
<!--===============================================================================================-->
<script src="assets/js/main.js"></script>
<!-- Global site tag (gtag.js) - Google Analytics -->
<script async src="https://www.googletagmanager.com/gtag/js?id=UA-23581568-13"></script>
<script>
window.dataLayer = window.dataLayer || [];
function gtag(){dataLayer.push(arguments);}
gtag('js', new Date());
gtag('config', 'UA-23581568-13');
</script>
</body>
</html>