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Add new functionality to make an appointment #163

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Add new functionality to make an appointment #163

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104 changes: 104 additions & 0 deletions appointment.html
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Original file line number Diff line number Diff line change
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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>Appointment Form</title>
<style>
/* CSS styles */
.appointment-form {
max-width: 400px;
margin: 0 auto;
padding: 20px;
border: 1px solid #ccc;
border-radius: 5px;
}

.form-group {
margin-bottom: 15px;
}

label {
display: block;
font-weight: bold;
}

input[type="text"],
input[type="email"],
textarea,
select {
width: 100%;
padding: 8px;
border: 1px solid #ccc;
border-radius: 5px;
}

button {
width: 100%;
padding: 10px;
background-color: #007bff;
color: #fff;
border: none;
border-radius: 5px;
cursor: pointer;
transition: background-color 0.3s;
}

button:hover {
background-color: #0056b3;
}
</style>
</head>
<body>

<!-- Your form goes here -->
<form action="submit_appointment.php" method="post" class="appointment-form">
<div class="form-group">
<label for="doctor">Select Doctor:</label>
<select id="doctor" name="doctor" required>
<option value="Dr. Smith">Dr. Smith</option>
<option value="Dr. Johnson">Dr. Johnson</option>
<!-- Add more options for other doctors -->
</select>
</div>

<div class="form-group">
<label for="name">Name:</label>
<input type="text" id="name" name="name" required>
</div>

<div class="form-group">
<label for="email">Email:</label>
<input type="email" id="email" name="email" required>
</div>

<div class="form-group">
<label for="phone">Phone:</label>
<input type="text" id="phone" name="phone" required>
</div>

<div class="form-group">
<label for="medical_history">Medical History or Notes:</label>
<textarea id="medical_history" name="medical_history"></textarea>
</div>

<div class="form-group">
<label for="date">Date:</label>
<input type="date" id="date" name="date" required>
</div>

<div class="form-group">
<label for="time">Time:</label>
<input type="time" id="time" name="time" required>
</div>

<div class="form-group">
<label for="reason">Reason for Appointment:</label>
<textarea id="reason" name="reason" required></textarea>
</div>

<button type="submit">Submit Appointment</button>
</form>

</body>
</html>