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contact-blood.php
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225 lines (196 loc) · 9.1 KB
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<?php
session_start();
error_reporting(0);
include('includes/config.php');
if (isset($_POST['send'])) {
$cid = $_GET['cid'];
$name = $_POST['fullname'];
$email = $_POST['email'];
$contactno = $_POST['contactno'];
$age = $_POST['age'];
$bloodgroup = $_POST['bloodgroup'];
$brf = $_POST['brf'];
$message = $_POST['message'];
$sql = "INSERT INTO tblbloodrequirer(BloodDonarID,name,EmailId,ContactNumber, Age,BloodGroup,BloodRequirefor,Message) VALUES(:cid,:name,:email,:contactno,:age,:bloodgroup,:brf,:message)";
$query = $dbh->prepare($sql);
$query->bindParam(':cid', $cid, PDO::PARAM_STR);
$query->bindParam(':name', $name, PDO::PARAM_STR);
$query->bindParam(':email', $email, PDO::PARAM_STR);
$query->bindParam(':contactno', $contactno, PDO::PARAM_STR);
$query->bindParam(':age', $age, PDO::PARAM_STR);
$query->bindParam(':bloodgroup', $bloodgroup, PDO::PARAM_STR);
$query->bindParam(':brf', $brf, PDO::PARAM_STR);
$query->bindParam(':message', $message, PDO::PARAM_STR);
$query->execute();
$lastInsertId = $dbh->lastInsertId();
if ($lastInsertId) {
echo '<script>alert("Request has been sent. We will contact you shortly.")</script>';
} else {
echo "<script>alert('Something went wrong. Please try again.');</script>";
}
}
?>
<!DOCTYPE html>
<html lang="zxx">
<head>
<title>Blood Bank Donar Management System | Blood Requerer </title>
<!-- Meta tag Keywords -->
<script>
addEventListener("load", function() {
setTimeout(hideURLbar, 0);
}, false);
function hideURLbar() {
window.scrollTo(0, 1);
}
</script>
<!--// Meta tag Keywords -->
<!-- Custom-Files -->
<link rel="stylesheet" href="css/bootstrap.css">
<!-- Bootstrap-Core-CSS -->
<link rel="stylesheet" href="css/style.css" type="text/css" media="all" />
<!-- Style-CSS -->
<link rel="stylesheet" href="css/fontawesome-all.css">
<!-- Font-Awesome-Icons-CSS -->
<!-- //Custom-Files -->
<!-- Web-Fonts -->
<link href="//fonts.googleapis.com/css?family=Open+Sans:300,300i,400,400i,600,600i,700,700i,800,800i&subset=cyrillic,cyrillic-ext,greek,greek-ext,latin-ext,vietnamese" rel="stylesheet">
<link href="//fonts.googleapis.com/css?family=Roboto+Condensed:300,300i,400,400i,700,700i&subset=cyrillic,cyrillic-ext,greek,greek-ext,latin-ext,vietnamese" rel="stylesheet">
<!-- //Web-Fonts -->
</head>
<body>
<?php include('includes/header.php'); ?>
<!-- banner 2 -->
<div class="inner-banner-w3ls">
<div class="container">
</div>
<!-- //banner 2 -->
</div>
<!-- page details -->
<div class="breadcrumb-agile">
<div aria-label="breadcrumb">
<ol class="breadcrumb">
<li class="breadcrumb-item">
<a href="index.php">Home</a>
</li>
<li class="breadcrumb-item active" aria-current="page">Blood Needed Person</li>
</ol>
</div>
</div>
<!-- //page details -->
<!-- contact -->
<div class="agileits-contact py-5">
<div class="py-xl-5 py-lg-3">
<div class="w3ls-titles text-center mb-5">
<h3 class="title">Contact For Blood</h3>
<span>
<i class="fas fa-user-md"></i>
</span>
</div>
<div class="d-flex">
<div class="col-lg-5 w3_agileits-contact-left">
</div>
<div class="col-lg-7 contact-right-w3l">
<h5 class="title-w3 text-center mb-5">
<h5 class="title-w3 text-center mb-5">Fill following form for blood</h5>
</h5>
<form action="#" method="post">
<div class="d-flex space-d-flex">
<div class="form-group grid-inputs">
<label for="recipient-name" class="col-form-label">Your Name</label>
<input type="text" class="form-control" id="name" name="fullname" placeholder="Please enter your name.">
</div>
<div class="form-group grid-inputs">
<label for="recipient-name" class="col-form-label">Phone Number</label>
<input type="tel" class="form-control" id="phone" name="contactno" placeholder="Please enter your phone number.">
</div>
<div class="form-group grid-inputs">
<label for="recipient-name" class="col-form-label">Age</label>
<input type="tel" class="form-control" id="age" name="age" placeholder="Please enter Age.">
</div>
<div class="form-group grid-inputs">
<label for="recipient-name" class="col-form-label">Blood Group</label>
<select name="bloodgroup" id="bloodgroup" class="form-control" required>
<?php $sql = "SELECT * from tblbloodgroup ";
$query = $dbh->prepare($sql);
$query->execute();
$results = $query->fetchAll(PDO::FETCH_OBJ);
$cnt = 1;
if ($query->rowCount() > 0) {
foreach ($results as $result) { ?>
<option value="<?php echo htmlentities($result->BloodGroup); ?>"><?php echo htmlentities($result->BloodGroup); ?></option>
<?php }
} ?>
</select>
</div>
</div>
<div class="d-flex space-d-flex">
<div class="form-group grid-inputs">
<label for="recipient-name" class="col-form-label">Email Address</label>
<input type="email" class="form-control" id="email" name="email" required placeholder="Please enter your email address.">
</div>
<div class="form-group grid-inputs">
<label for="recipient-name" class="col-form-label">Blood Require For</label>
<select class="form-control" id="phone" name="brf">
<option value="">Blood Require For</option>
<option value="Father">Father</option>
<option value="Mother">Mother</option>
<option value="Brother">Brother</option>
<option value="Sister">Sister</option>
<option value="Others">Others</option>
</select>
</div>
</div>
<div class="form-group">
<label for="recipient-name" class="col-form-label">Message</label>
<textarea rows="10" cols="100" class="form-control" id="message" name="message" placeholder="Please enter your message" maxlength="999" style="resize:none"></textarea>
</div>
<div class="form-group">
<input type="submit" value="Send Message" name="send">
</div>
</form>
</div>
</div>
</div>
</div>
<!-- //contact -->
<?php include('includes/footer.php'); ?>
<!-- Js files -->
<!-- JavaScript -->
<script src="js/jquery-2.2.3.min.js"></script>
<!-- Default-JavaScript-File -->
<!-- banner slider -->
<script src="js/responsiveslides.min.js"></script>
<script>
$(function() {
$("#slider4").responsiveSlides({
auto: true,
pager: true,
nav: true,
speed: 1000,
namespace: "callbacks",
before: function() {
$('.events').append("<li>before event fired.</li>");
},
after: function() {
$('.events').append("<li>after event fired.</li>");
}
});
});
</script>
<!-- //banner slider -->
<!-- fixed navigation -->
<script src="js/fixed-nav.js"></script>
<!-- //fixed navigation -->
<!-- smooth scrolling -->
<script src="js/SmoothScroll.min.js"></script>
<!-- move-top -->
<script src="js/move-top.js"></script>
<!-- easing -->
<script src="js/easing.js"></script>
<!-- necessary snippets for few javascript files -->
<script src="js/medic.js"></script>
<script src="js/bootstrap.js"></script>
<!-- Necessary-JavaScript-File-For-Bootstrap -->
<!-- //Js files -->
</body>
</html>