/home3/vehiclea/public_html/apbreastcentre/appointment-2.php
<?php
error_reporting(0);
if(isset($_POST['appointmentbtn']))
{
$name = $_POST["name"];
$mobile = $_POST["phone"];
$date = $_POST["date"];
$time = $_POST["time"];
$email = $_POST["email"];
$enquiry = $_POST["message"];
$from = 'appointment@apbreastcenter.com';
$to = 'drpriyanka@apbreastcentre.com';
$headers = "MIME-Version: 1.0" . "\r\n";
$headers .= "Content-type:text/html;charset=UTF-8" . "\r\n";
$headers .= 'From: '.$from.''. "\r\n" .
'Reply-To: '.$from.'' . "\r\n" .
'X-Mailer: PHP/' . phpversion();
$subjectmail = "Appointment Info From AP Breast Center Website";
$message = '<html>
<head>
<title>' . $subjectmail . '</title>
</head>
<body>
<p style="text-align:left;">Hello Doctor,<br><br>Contact Details are as follows :<br><br>
<strong>Name : </strong>' . $name . '<br>
<strong>Phone Number : </strong>' . $mobile . '<br>
<strong>Appointment Date : </strong>' . $date . '<br>
<strong>Appointment Time : </strong>' . $time . '<br>
<strong>EmailID : </strong>' . $email . '<br>
<strong>Message : </strong>' . $enquiry . '<br>
<br><br>
Thanks and Regards,<br>
<strong>Web Administrator,</strong><br>
AP Breast Center.<br>
URL: https://www.apbreastcenter.com/
</p></body></html>';
if(mail($to, $subjectmail, $message, $headers))
{
//we show the good guy only in one case and the bad one for the rest.
header('refresh:0;url=appointment-2.php');
?>
<script>
alert('Thank you <?php error_reporting(0); echo $name; ?>. We will contact you soon.');
</script>
<?php
}
else
{
header('refresh:0;url=appointment-2.php');
?>
<script>
alert('Something Went Wrong. Please Try Again Later. Thank you.');
</script>
<?php
}
}
?>
<?php
$page="patients";
$title= "AP Breast Centre";
$metadescription = "";
include 'header.php';?>
<div class="page-title-area page-title-bg2 hidden-xs">
<div class="d-table">
<div class="d-table-cell">
<div class="container">
<div class="page-title-content">
<h2>Appointment</h2>
<ul>
<li><a href="index">Home</a></li>
<li>Book An Appointment</li>
</ul>
</div>
</div>
</div>
</div>
</div>
<div class="page-title-area page-title-bg1mobile visible-xs">
<div class="d-table">
<div class="d-table-cell">
<div class="container">
<div class="page-title-content">
<h2>Appointment</h2>
<ul>
<li><a href="index">Home</a></li>
<li>Book An Appointment</li>
</ul>
</div>
</div>
</div>
</div>
</div>
<section class="contact-area ptb-800">
<div class="container">
<div class="services-title-content">
<center><span class="sub-title">Message Us</span>
<h2>Book An Appointment</h2>
<span class="animate-border mr-auto ml-auto mb-4"></span>
<p class="maxiumstrectssmin">The AP Breast Centre brings you the hope also together every available resource to provide attentive & sensitive care for women</p></center>
</div>
<div class="contact-inner">
<div class="row m-0">
<div class="col-lg-1 col-md-1 col-sm-12"></div>
<div class="col-lg-10 col-md-10 col-sm-12">
<div class="contact-form">
<form method="post" action="appointment-2.php">
<div class="row">
<div class="col-lg-6 col-md-6">
<div class="form-group">
<label><i class="flaticon-user"></i></label>
<input type="text" name="name" class="form-control" placeholder="Your Name" required>
</div>
</div>
<div class="col-lg-6 col-md-6">
<div class="form-group">
<label><i class="fa fa-phone"></i></label>
<input type="text" name="phone" class="form-control" placeholder="Your Phone" required>
</div>
</div>
<div class="col-lg-6 col-md-6">
<div class="form-group">
<label><i class="fa fa-calendar"></i></label>
<input type="date" name="date" class="form-control" placeholder="Appointment Date" required>
</div>
</div>
<div class="col-lg-6 col-md-6">
<div class="form-group">
<label><i class="fa fa-clock"></i></label>
<input type="time" name="time" class="form-control" placeholder="Appointment Time" required>
</div>
</div>
<div class="col-lg-12 col-md-12">
<div class="form-group">
<label><i class="flaticon-email"></i></label>
<input type="email" name="email" class="form-control" placeholder="Your Email" required>
</div>
</div>
<div class="col-lg-12 col-md-12">
<div class="form-group">
<label><i class="flaticon-list"></i></label>
<textarea name="message" class="form-control" cols="30" rows="6" placeholder="Your Message" required></textarea>
</div>
</div>
<div class="col-lg-12 col-md-12">
<center><button type="submit" name="appointmentbtn" class="btn btn-primary">Send Message <i class="fas fa-paper-plane"></i></button></center>
<div class="clearfix"></div>
</div>
</div>
</form>
</div>
</div>
<div class="col-lg-1 col-md-1 col-sm-12"></div>
</div>
</div>
</div>
</section>
<?php include 'footer.php';?>
@LwBee Strong Bypass
Upload File
Create New File