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addpat.html
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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>MEDCON</title>
<link rel="icon" type="image/x-icon" href="logo.jpg">
<link rel="stylesheet" href="style.css">
<link href="https://cdn.jsdelivr.net/npm/[email protected]/dist/css/bootstrap.min.css" rel="stylesheet" integrity="sha384-1BmE4kWBq78iYhFldvKuhfTAU6auU8tT94WrHftjDbrCEXSU1oBoqyl2QvZ6jIW3" crossorigin="anonymous">
<link rel="stylesheet" href="https://cdn.jsdelivr.net/npm/[email protected]/font/bootstrap-icons.css">
</head>
<body id="body-pd">
<header class="header" id="header">
<div class="header_toggle"> <i class='bi bi-list' id="header-toggle"></i> </div>Hello User !
<div class="header_img"> <img src="pro.jpg" alt=""> </div>
</header>
<div class="l-navbar" id="nav-bar">
<nav class="nav">
<div> <a href="#" class="nav_logo links"> <i class='bi bi-layer nav_logo-icon'></i> <span class="nav_logo-name"><p style="font-size: 40px;">Medcon</p></span> </a>
<div class="nav_list"> <a href="dash.html" class="nav_link links"> <i class='bi bi-house'></i> <span class="nav_name">Dashboard</span> </a> <a href="Patients.html" class="nav_link links"> <i class='bi bi-people-fill nav_icon'></i> <span class="nav_name">Patients</span> </a> <a href="doctors.html" class="nav_link active links"> <i class='bi bi-bi bi-person-check-fill'></i> <span class="nav_name">Doctors</span> </a> </div>
</div> <a href="login.html" class="nav_link links"> <i class='bi bi-box-arrow-left nav_icon'></i> <span class="nav_name">SignOut</span> </a>
</nav>
</div>
<div class="height-100 ">
<div class="stage">
<div class="container-fluid px-1 py-5 mx-auto">
<div class="row d-flex justify-content-center">
<div class="col-xl-7 col-lg-8 col-md-9 col-11 text-center">
<h3>Enter patient details</h3>
<div class="card_pat">
<h5 class="text-center mb-4">Patient Report</h5>
<form class="form-card" onsubmit="event.preventDefault()">
<div class="row justify-content-between text-left">
<div class="form-group col-sm-6 flex-column d-flex"> <label class="form-control-label px-3">UID<span class="text-danger"> *</span></label> <input type="number" id="fname" name="fname" placeholder="" onblur="validate(1)"> </div>
<div class="form-group col-sm-6 flex-column d-flex"> <label class="form-control-label px-3">Name<span class="text-danger"> *</span></label> <input type="text" id="lname" name="lname" placeholder="" onblur="validate(2)"> </div>
</div>
<div class="row justify-content-between text-left">
<div class="form-group col-sm-6 flex-column d-flex"> <label class="form-control-label px-3">Doctor<span class="text-danger"> *</span></label> <input type="text" id="email" name="email" placeholder="" onblur="validate(3)"> </div>
<div class="form-group col-sm-6 flex-column d-flex"> <label class="form-control-label px-3">Diagnosis<span class="text-danger"> *</span></label> <input type="text" id="mob" name="mob" placeholder="" onblur="validate(4)"> </div>
</div>
<div class="row justify-content-between text-left">
<div class="form-group col-sm-6 flex-column d-flex"> <label class="form-control-label px-3">Remark<span class="text-danger"> *</span></label> <input type="text" id="job" name="job" placeholder="" onblur="validate(5)"> </div>
</div>
<div class="row justify-content-between text-left">
<div class="form-group col-12 flex-column d-flex"> <label class="form-control-label px-3">Medical Report<span class="text-danger"> *</span></label> <input type="text" id="ans" name="ans" placeholder="" onblur="validate(6)"> </div>
</div>
<div class="row justify-content-end mt-5">
<div class="form-group col-sm-6"> <button type="reset" class="btn-block btn-sub">Submit</button> </div>
</div>
</form>
</div>
</div>
</div>
</div>
</div>
</div>
<script src="https://code.jquery.com/jquery-3.6.0.min.js" integrity="sha256-/xUj+3OJU5yExlq6GSYGSHk7tPXikynS7ogEvDej/m4=" crossorigin="anonymous"></script>
<script src="https://cdn.jsdelivr.net/npm/@popperjs/[email protected]/dist/umd/popper.min.js" integrity="sha384-7+zCNj/IqJ95wo16oMtfsKbZ9ccEh31eOz1HGyDuCQ6wgnyJNSYdrPa03rtR1zdB" crossorigin="anonymous"></script>
<script src="https://cdn.jsdelivr.net/npm/[email protected]/dist/js/bootstrap.min.js" integrity="sha384-QJHtvGhmr9XOIpI6YVutG+2QOK9T+ZnN4kzFN1RtK3zEFEIsxhlmWl5/YESvpZ13" crossorigin="anonymous"></script>
<script src="script.js"></script>
</body>
</html>