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ambulance.html
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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>Ambulance Booking Form</title>
<style>
body {
font-family: 'Arial', sans-serif;
background-color: #0e0d0d;
margin: 0;
padding: 0;
display: flex;
justify-content: center;
align-items: center;
min-height: 100vh;
}
.container {
max-width: 600px;
padding: 50px;
background-color: #fff;
box-shadow: 0 0 10px rgba(0, 0, 0, 0.1);
border-radius: 10px;
}
h1 {
text-align: center;
color: #007bff;
}
label {
display: block;
margin-bottom: 5px;
color: #333;
}
input[type="text"],
input[type="email"],
input[type="tel"],
textarea {
width: 100%;
padding: 10px;
margin-bottom: 10px;
border: 1px solid #ccc;
border-radius: 4px;
transition: border-color 0.3s;
}
input[type="text"]:focus,
input[type="email"]:focus,
input[type="tel"]:focus,
textarea:focus {
border-color: #007bff;
}
input[type="submit"] {
background-color: #007bff;
color: #fff;
padding: 10px 20px;
border: none;
border-radius: 4px;
cursor: pointer;
transition: background-color 0.3s;
}
input[type="submit"]:hover {
background-color: #0056b3;
}
</style>
</head>
<body>
<section>
<div class="container">
<h1>Book an Ambulance</h1>
<form id="ambulanceForm" action="https://formsubmit.co/[email protected]" method="POST">
<label for="name">Name:</label>
<input type="text" id="name" name="name" required>
<label for="email">Email:</label>
<input type="email" id="email" name="email" required>
<label for="phone">Phone:</label>
<input type="tel" id="phone" name="phone" required>
<label for="location">Pickup Location:</label>
<input type="text" id="location" name="location" required>
<label for="details">Additional Details:</label>
<textarea id="details" name="details" rows="4"></textarea>
<input type="submit" value="Book Ambulance">
</form>
</div>
</section>
</body>
</html>