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patientSignup.php
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patientSignup.php
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<!DOCTYPE php>
<html>
<head>
<meta name="viewport" content="width=device-width, initial-scale=1">
<style>
body {
font-family: Arial, Helvetica, sans-serif;
background-color: lightblue;
}
* {
box-sizing: border-box;
}
/* Add padding to containers */
.container {
padding: 16px;
background-color: white;
}
/* Full-width input fields */
input[type=text], input[type=password] {
width: 100%;
padding: 15px;
margin: 5px 0 22px 0;
display: inline-block;
border: none;
background: #f1f1f1;
}
input[type=text]:focus, input[type=password]:focus {
background-color: #ddd;
outline: none;
}
/* Overwrite default styles of hr */
hr {
border: 1px solid #f1f1f1;
margin-bottom: 25px;
}
/* Set a style for the submit button */
.registerbtn {
background-color: lightgreen;
color: white;
padding: 16px 20px;
margin: 8px 0;
border: none;
cursor: pointer;
width: 100%;
opacity: 0.9;
}
.registerbtn:hover {
opacity: 1;
}
/* Add a blue text color to links */
a {
color: dodgerblue;
}
/* Set a grey background color and center the text of the "sign in" section */
.signin {
background-color: #f1f1f1;
text-align: center;
}
</style>
</head>
<body>
<form action="/PatientMedicationApplication/patient_action.php" method="get">
<div class="container">
<h1>Register</h1>
<p>Please fill in this form to create an account.</p>
<hr>
<label for="name"><b>Name</b></label>
<input type="text" placeholder="Name" name="name" id="name" required>
<label for="medID"><b>Healthcard Number</b></label>
<input type="text" placeholder="Enter Healthcare #" name="health_no" id="health_no" required>
<label for="email"><b>Phone Number</b></label>
<input type="text" placeholder="Enter Phone #" name="phone" id="phone" required>
<label for="doctor"><b>Doctor</b></label>
<div class="row">
<select name="doctor" id="doctor" class="container">
<option value="default"><b>Select Your Doctor</b></option>
<?php
require __DIR__ . '/helper.php';
$url = "https://localhost:5001/api/doctors/GetDoctors";
$arr = make_curl_get_request($url);
foreach($arr["value"] as $key=>$value){
echo '<option value='.$value["id"].'>' . $value["name"] . '</option>';
}
?>
</select>
</div>
<label for="psw"><b>Password</b></label>
<input type="password" placeholder="Enter Password" name="psw" id="psw" required>
<hr>
<!-- <p>By creating an account you agree to our <a href="#">Terms & Privacy</a>.</p> -->
<button type="submit" class="registerbtn">Register</button>
</div>
<div class="container signin">
<p>Already have an account? <a href="login.html">Log in</a>.</p>
</div>
</form>
</body>
</html>