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appointment.html
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<!DOCTYPE html>
<html lang="en">
<!-- Mirrored from jollythemes.com/html/jollymedic/appointment.html by HTTrack Website Copier/3.x [XR&CO'2014], Tue, 28 Feb 2017 15:29:12 GMT -->
<head>
<script type="text/javascript">
function validateForm()
{
var a=document.forms["Form"]["date"].value;
var today = new Date();
var dd = today.getDate();
var mm = today.getMonth()+1; //January is 0!
var yyyy = today.getFullYear();
if(dd<10){
dd='0'+dd;
}
if(mm<10){
mm='0'+mm;
}
var today = mm+'/'+dd+'/'+yyyy;
var max="2019-03-27";
var min="2017-07-20";
//var timeDiff = Math.abs(today.getTime()-a.getTime());
//var diffDays = Math.ceil(timeDiff / (1000 * 3600 * 24));
if (a<min || a>max)
{
document.getElementById("date").innerHTML = "Expiry Date needs to be between 2 month and 2 year";
document.getElementById("date").style.color = "red";
// document.getElementById("date").style.font-weight = "bold";
return false;
}
}
</script>
<meta http-equiv="content-type" content="text/html; charset=UTF-8">
<title>Give Bangladesh</title>
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<meta name="description" content="">
<meta name="keywords" content="">
<meta name="author" content="">
<!-- Bootstrap Styles -->
<link href="css/bootstrap.css" rel="stylesheet">
<script src="https://code.jquery.com/jquery-2.2.0.min.js"></script>
<link href="css/main.css" rel="stylesheet" type="text/css">
<!-- Awesome Icons -->
<link rel="stylesheet" href="css/font-awesome.css">
<!-- Flexslider -->
<link href="css/flexslider.css" rel="stylesheet">
<!-- Carousel -->
<link href="css/owl-carousel.css" rel="stylesheet">
<!-- SLIDER REVOLUTION 4.x CSS SETTINGS -->
<link rel="stylesheet" type="text/css" href="rs-plugin/css/settings.css" media="screen" />
<!-- Styles -->
<link href="style.css" rel="stylesheet">
<!-- Google Fonts -->
<link href='http://fonts.googleapis.com/css?family=Lato:400,400italic,700,700italic,900,300' rel='stylesheet' type='text/css'>
<link href='http://fonts.googleapis.com/css?family=Roboto:400,300,300italic,400italic,500,500italic,700,700italic,900' rel='stylesheet' type='text/css'>
<!-- Support for HTML5 -->
<!--[if lt IE 9]>
<script src="js/html5shiv.js"></script>
<![endif]-->
<!-- Enable media queries on older bgeneral_rowsers -->
<!--[if lt IE 9]>
<script src="js/respond.min.js"></script> <![endif]-->
</head>
<body>
<div class="animationload">
<div class="loader">Loading...</div>
</div>
<div class="topbar">
<div class="container">
<div class="row">
<div class="col-lg-6 col-md-6 col-sm-12">
</div><!-- end col -->
<div class="col-lg-6 col-md-6 col-sm-12">
<div class="topbar_social pull-right">
<a href="prog.php"><i class="fa fa-user"></i> Profile</a>
</div><!-- end social icons -->
</div><!-- end col -->
</div><!-- end row -->
</div><!-- end container -->
</div><!-- end topbar -->
<header class="header">
<div class="container">
<nav class="navbar yamm navbar-default">
<div class="navbar-header">
<button type="button" data-toggle="collapse" data-target="#navbar-collapse-1" class="navbar-toggle">
<span class="icon-bar"></span>
<span class="icon-bar"></span>
<span class="icon-bar"></span>
</button>
<a href="index.html" class="navbar-brand"><img src="images/logo.png" alt="GiveBd"></a>
</div><!-- end navbar-header -->
<div id="navbar-collapse-1" class="navbar-collapse collapse navbar-right">
<ul class="nav navbar-nav">
<li><a href="index.php">Home</a></li>
<li class="dropdown"><a id="active" href="#" data-toggle="dropdown" class="dropdown-toggle">Service </a>
<ul class="dropdown-menu" role="menu">
<li><a href="appointment.html">Medicine Donation</a></li>
<li><a href="404.html">Money Donation</a></li>
<li><a href="404.html">Cloth Donation</a></li>
<li><a href="404.html">Blood Donation</a></li>
</ul><!-- end dropdown-menu -->
</li><!-- end standard drop down -->
<li class="dropdown"><a href="#" data-toggle="dropdown" class="dropdown-toggle">Medicine Catagory</a>
<ul class="dropdown-menu" role="menu">
<li><a href="medicine.php">Old People</a></li>
<li><a href="medicine.php">Child</a></li>
<li><a href="medicine.php">For All</a></li>
</ul><!-- end dropdown-menu -->
</li><!-- end standard drop down -->
</li><!-- end drop down -->
<li><a href="#contact">Contact Us</a></li>
</ul><!-- end navbar-nav -->
</div><!-- #navbar-collapse-1 -->
</nav><!-- end navbar yamm navbar-default -->
</div><!-- end container -->
</header><!-- end header -->
<div class="shadow"></div>
<div class="post-wrapper-top clearfix">
<div class="container">
<div class="col-lg-12">
<h2>Donate Here</h2>
<ul class="breadcrumb pull-right">
<li><a class="active" href="index.html">Home</a></li>
<li style="font-size: 20px;">Donation Form</li>
</ul>
</div>
</div>
</div><!-- end post-wrapper-top -->
<div class="white-wrapper">
<div class="container">
<div id="content" class="col-lg-8 col-md-8 col-sm-8 col-xs-12">
<form role="form" class="row online_form_builder_big" name="Form"
method="get" onsubmit="return validateForm()" action="a1.php" autocomplete="off">
<div class="clearfix"></div>
<br>
<div class="col-md-6 autocomplete">
<label for="first_name">Medicine Name (required)</label>
<input type="text" class="form-control" name="name" id="medicine" placeholder="" required>
</div>
<div class="dialog">
</div>
<div class="col-md-6 auto">
<label for="first_name">Medicine Company Name (required)</label>
<input type="text" class="form-control" id="first_name" placeholder="" name="company" required>
</div><div class="d"></div>
<div class="clearfix"></div>
<br>
<div class="col-md-6">
<label>Quantity (Total- between 20 to 200)</label>
<input class="form-control" type="number" name="quantity" min="20" max="200" required>
</div>
<div class="col-md-6">
<label >Address to Receive Medicine</label>
<input class="form-control" type="text" name="address" required>
</div>
<div class="clearfix"></div>
<br>
<div class="col-md-6">
<label id="date">Expiry Date</label>
<input class="form-control" type="date" name="date" id="a" required max="2020-01-31" min="2017-03-01">
</div>
<div class="clearfix"></div>
<br><br>
<div class="col-md-3">
<button class="btn btn-primary" style="position:relative; margin-left: 190px;">Donate Now</button>
</div>
<button class="btn btn-primary" style="position:relative; margin-left: 200px;">Donate More </button>
</form>
</div><!-- end content -->
<div id="sidebar" class="col-lg-4 col-md-4 col-sm-4 col-xs-12">
<div class="widget">
<div id="tabbed_widget" class="tabbable">
<ul class="nav nav-tabs">
<li class="active"><a href="#recent" data-toggle="tab">RECENT</a></li>
<li><a href="#new" data-toggle="tab">POPULAR</a></li>
<li><a href="#commentstab" data-toggle="tab">FEEDBACK</a></li>
</ul>
<div class="tab-content">
<div class="tab-pane active" id="recent">
<ul class="recent_posts_widget">
<li>
<a href="#"><img src="demos/1.jpg" alt="" />Medicine for fever</a>
<a class="readmore_widget" href="#">Napa</a>
</li>
<li>
<a href="#"><img src="demos/55.jpg" alt="" />Medicine for cold</a>
<a class="readmore_widget" href="#">Flazil</a>
</li>
<li>
<a href="#"><img src="demos/1.jpg" alt="" />Medicine for back pain</a>
<a class="readmore_widget" href="#">Foxa</a>
</li>
</ul><!-- recent posts -->
</div>
<div class="tab-pane" id="new">
<ul class="recent_posts_widget">
<li>
<a href="#"><img src="demos/1.jpg" alt="" />Medicine for headache</a>
<a class="readmore_widget" href="#">Aspirin</a>
<div class="rating">
<i class="fa fa-star"></i>
<i class="fa fa-star"></i>
<i class="fa fa-star"></i>
<i class="fa fa-star"></i>
<i class="fa fa-star-o"></i>
</div><!-- rating -->
</li>
<li>
<a href="#"><img src="demos/55.jpg" alt="" />Medicine for cold</a>
<a class="readmore_widget" href="#">Napa extra</a>
<div class="rating">
<i class="fa fa-star"></i>
<i class="fa fa-star"></i>
<i class="fa fa-star"></i>
<i class="fa fa-star"></i>
<i class="fa fa-star"></i>
</div><!-- rating -->
</li>
<li>
<a href="#"><img src="demos/1.jpg" alt="" />Medicine for diarrhea</a>
<a class="readmore_widget" href="#">Omaprazol</a>
<div class="rating">
<i class="fa fa-star"></i>
<i class="fa fa-star"></i>
<i class="fa fa-star"></i>
<i class="fa fa-star"></i>
<i class="fa fa-star-o"></i>
</div><!-- rating -->
</li>
</ul><!-- recent posts -->
</div>
<div class="tab-pane" id="commentstab">
<ul class="recent_posts_widget">
<li>
<a href="#"><img src="demos/client_01.jpg" alt="" />Ash: This site is a life saver</a>
<a class="readmore_widget" href="#">January 09, 2017</a>
<div class="rating">
<i class="fa fa-star"></i>
<i class="fa fa-star"></i>
<i class="fa fa-star"></i>
<i class="fa fa-star"></i>
<i class="fa fa-star-o"></i>
</div><!-- rating -->
</li>
<li>
<a href="#"><img src="demos/client_02.jpg" alt="" />Nafin: Best medicine distribution site.</a>
<a class="readmore_widget" href="#">Feburay 16, 2016</a>
<div class="rating">
<i class="fa fa-star"></i>
<i class="fa fa-star"></i>
<i class="fa fa-star"></i>
<i class="fa fa-star"></i>
<i class="fa fa-star"></i>
</div><!-- rating -->
</li>
<li>
<a href="#"><img src="demos/client_01.jpg" alt="" />Suha: This is a helpful site.</a>
<a class="readmore_widget" href="#">Feburay 16, 2015</a>
<div class="rating">
<i class="fa fa-star"></i>
<i class="fa fa-star"></i>
<i class="fa fa-star"></i>
<i class="fa fa-star"></i>
<i class="fa fa-star-o"></i>
</div><!-- rating -->
</li>
</ul><!-- recent posts -->
</div>
</div><!-- end tab content -->
</div><!-- end tab pane -->
</div><!-- end widget -->
</div><!-- end sidebar -->
</div><!-- end container -->
</div><!-- end white-wrapper -->
<!--footer-->
<div class="custom-wrapper" id="contact">
<div class="container">
<div class="newsletter_wrapper">
<h4 style="color:white;">Over <mark>100,000</mark> People Trust us. Get free Medicine<br>
And Donate Your Spare Medicine, Subscribe us</h4>
<div class="row margin-top">
<form id="loginform" method="post" name="loginform">
<div class="col-md-4">
<div class="form-group">
<div class="input-group">
<span class="input-group-addon"><i class="fa fa-user"></i></span>
<input type="text" class="form-control" placeholder="Your Name">
</div>
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<div class="input-group">
<span class="input-group-addon"><i class="fa fa-envelope"></i></span>
<input type="text" class="form-control" placeholder="Your Email Address">
</div>
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<div class="input-group">
<span class="input-group-addon"><i class="fa fa-phone"></i></span>
<input type="text" class="form-control" placeholder="Your Phone Number">
</div>
</div>
</div>
<div class="clearfix"></div><br>
<button class="btn btn-default btn-lg" style="background:#0EB8EA;">Subscribe Now</button>
</form>
</div>
</div><!-- end newsletter_wrapper -->
</div><!-- end container -->
</div><!-- end custom_wrapper -->
<div class="copyright">
<div class="container">
<div class="row">
<!-- <div class="col-lg-5 col-md-6 col-sm-12">-->
<div class="copyright-text" style="text-align:center;">
<p>Copyright © 2017 - GIVEBangladesh Medicine Donation Website</p>
</div><!-- end copyright-text -->
</div><!-- end widget -->
<!-- <div class="col-lg-7 col-md-6 col-sm-12">
<div class="footer-menu">
<ul class="menu pull-right">
<li class="active"><a href="#">Home</a></li>
<li><a href="#">Service</a></li>
<li><a href="#">Med Catagory</a></li>
<li><a href="#">Feedback</a></li>
<li><a href="#">About Us</a></li>
<li><a href="#">FAQ</a></li>
<li><a href="#">Contact Us</a></li>
</ul>
</div>
</div><! end large-7 -->
<!-- </div><! end row -->
</div><!-- end container -->
</div><!-- end copyrights -->
<div class="dmtop">Scroll to Top</div>
<!-- Main Scripts-->
<script src="js/jquery.js"></script>
<script src="js/bootstrap.min.js"></script>
<script src="js/bootstrap-datetimepicker.js"></script>
<script src="js/menu.js"></script>
<script src="js/retina-1.1.0.js"></script>
<script src="js/custom.js"></script>
<script src="js/main.js"></script>
<!-- CALENDAR WIDGET -->
</body>
<!-- Mirrored from jollythemes.com/html/jollymedic/appointment.html by HTTrack Website Copier/3.x [XR&CO'2014], Tue, 28 Feb 2017 15:29:16 GMT -->
</html>