-
Notifications
You must be signed in to change notification settings - Fork 8
/
Copy pathblood_request.php
executable file
·226 lines (194 loc) · 11.6 KB
/
blood_request.php
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
<?php include("./backend/init.php"); ?>
<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<meta name="description" content="">
<meta name="author" content="">
<script src="js/modernizr.js"></script> <!-- Modernizr -->
<title>Request Blood | NSS IIT Patna</title>
<!-- core CSS -->
<link href="css/bootstrap.min.css" rel="stylesheet">
<link href="css/font-awesome.min.css" rel="stylesheet">
<link href="css/animate.min.css" rel="stylesheet">
<link href="css/prettyPhoto.css" rel="stylesheet">
<link href="css/owl.carousel.min.css" rel="stylesheet">
<link href="css/icomoon.css" rel="stylesheet">
<link href="css/main.css" rel="stylesheet">
<link href="css/responsive.css" rel="stylesheet">
<link rel="stylesheet" href="path/to/font-awesome/css/font-awesome.min.css">
<!--[if lt IE 9]>
<script src="js/html5shiv.js"></script>
<script src="js/respond.min.js"></script>
<![endif]-->
<link rel="shortcut icon" href="images/mainNSS/blood.png">
<link rel="stylesheet" href="css/reset.css"> <!-- CSS reset -->
<link rel="stylesheet" href="css/style.css"> <!-- Resource style -->
<!--Imported for the form only -->
<!--===============================================================================================-->
<link rel="icon" type="image/png" href="images/icons/favicon.ico"/>
<!--===============================================================================================-->
<link rel="stylesheet" type="text/css" href="fonts/font-awesome-4.7.0/css/font-awesome.min.css">
<!--===============================================================================================-->
<link rel="stylesheet" type="text/css" href="vendor/animate/animate.css">
<!--===============================================================================================-->
<link rel="stylesheet" type="text/css" href="vendor/css-hamburgers/hamburgers.min.css">
<!--===============================================================================================-->
<link rel="stylesheet" type="text/css" href="vendor/animsition/css/animsition.min.css">
<!--===============================================================================================-->
<link rel="stylesheet" type="text/css" href="vendor/select2/select2.min.css">
<!--===============================================================================================-->
<link rel="stylesheet" type="text/css" href="vendor/daterangepicker/daterangepicker.css">
<!--===============================================================================================-->
<link rel="stylesheet" type="text/css" href="css/util.css">
<link rel="stylesheet" type="text/css" href="css/main_blood.css">
<!--===============================================================================================-->
</head>
<!--/head-->
<body>
<header id="header" class="sticky">
<nav class="navbar navbar-inverse" role="banner">
<div class="container">
<div class="navbar-header">
<button type="button" class="navbar-toggle" data-toggle="collapse" data-target=".navbar-collapse">
<span class="sr-only">Toggle navigation</span>
<span class="icon-bar"></span>
<span class="icon-bar"></span>
<span class="icon-bar"></span>
</button>
<a class="navbar-brand" href="index.html"><img src="images/mainNSS/nssweb.png" alt="logo" style="width: 150px; height: auto"></a>
</div>
<div class="collapse navbar-collapse navbar-right">
<ul class="nav navbar-nav">
<li ><a href="index.html">Home</a></li>
<li class="dropdown">
<a href="#" class="dropdown-toggle" data-toggle="dropdown">Get Involved<i class="fa fa-angle-down"></i></a>
<ul class="dropdown-menu">
<li><a href="about-us.html">About Us</a></li>
<li><a href="team.html">Our Team</a></li>
<li><a href="faq.html">Faqs</a></li>
<li><a href="./mag.html">Magazine 2k18-19</a></li>
<li><a href="https://docs.google.com/document/d/1EgpxEHza7NJGcw6CV3m7fv25ZJsbJpALqj1VH3ZOTl8/edit" target="_blank">Rules & Policies</a></li>
</ul>
</li>
<li class="dropdown">
<a href="#" class="dropdown-toggle" data-toggle="dropdown">Units <i class="fa fa-angle-down"></i></a>
<ul class="dropdown-menu">
<li><a href="adhyayan.html">Adhyayan</a></li>
<li><a href="bcells/cells.html?cell=technical">Technical Skills</a></li>
<li><a href="cells/cells.html?cell=rural">Rural Development</a></li>
<li><a href="cells/cells.html?cell=chetna">Chetna</a></li>
<li><a href="cells/cells.html?cell=teaching">Teaching</a></li>
<li><a href="cells/cells.html?cell=environment">Environmental</a></li>
<li><a href="prayatna/prayatna.html">Prayatna</a></li>
</ul>
</li>
<li><a href="team.html">Our Team</a></li>
<li><a href="events.html">Events</a></li>
<li><a href="portfolio.html">Gallery</a></li>
<li><a href="think_thank.html">Think-Thank</a></li>
<li><a href="./profile/login.php">Check-Hours</a></li>
<li><a href="./blood_request.php">Blood Request</a></li>
<li><a href="./help.html">Help!</a></li>
</ul>
</div>
</div>
<!--/.container-->
</nav>
<!--/nav-->
</header>
<div class="page-title" style="background-image: url(images/mainNSS/blood_request.jpg); background-repeat: no-repeat; background-size: 100% 100%;height: 200px; margin-top: 78px">
</div>
<!--Form start here-->
<div class="container-contact100">
<div class="wrap-contact100">
<div class="alert" style="display:Block"><?php blood_request() ?></div>
<form class="contact100-form validate-form" id="bloodRequestForm" method="post">
<span class="contact100-form-title">
Request Blood
</span>
<div class="wrap-input100 validate-input" data-validate="Name is required">
<span class="label-input100">Your Name</span>
<input class="input100" type="text" name="BName" placeholder="Enter your name here..." id="BName" required>
<span class="focus-input100"></span>
</div>
<div class="wrap-input100 validate-input" >
<span class="label-input100">Roll No/Employee ID if from IIT Patna</span>
<input class="input100" type="text" name="BRoll" font-size="12px" placeholder="Enter your Roll No/Employee ID here..." id="BRoll" required>
<span class="focus-input100"></span>
</div>
<div class="wrap-input100 validate-input" data-validate = "Valid email is required: ex@abc.xyz">
<span class="label-input100">Email</span>
<input class="input100" type="email" name="BEmail" placeholder="Enter your email id here..." id="BEmail" required>
<span class="focus-input100"></span>
</div>
<div class="wrap-input100 validate-input" pattern="[6-9]{1}[0-9]{9}" data-validate="Valid phone is required: 3456789121">
<span class="label-input100">Phone Number</span>
<input class="input100" type="text" name="BPhone" placeholder="Enter your phone number here..." id="BPhone" required>
<span class="focus-input100"></span>
</div>
<div class="wrap-input100 validate-input" >
<span class="label-input100">For whom do you want Blood Doner card? </span>
<input class="input100" type="text" name="BForWhom" font-size="12px" placeholder="Enter for whom you want to take blood doner card..." id="BForWhom" required>
<span class="focus-input100"></span>
</div>
<div class="wrap-input100 validate-input" data-validate = "Message is required">
<span class="label-input100">Address</span>
<textarea class="input100" name="BAddress" placeholder="Write your address here..." id="BAddress" required></textarea>
<span class="focus-input100"></span>
</div>
<div class="container-contact100-form-btn">
<div class="wrap-contact100-form-btn">
<div class="contact100-form-bgbtn"></div>
<button class="contact100-form-btn" type="submit" name="submit_request">
<span>
Submit
<i class="fa fa-long-arrow-right m-l-7" aria-hidden="true"></i>
</span>
</button>
</div>
</div>
</form>
</div>
</div>
<iframe src="footer.html" frameborder="0" style="width: 100%; height:32vh"></iframe>
<!--===============================================================================================-->
<script src="vendor/jquery/jquery-3.2.1.min.js"></script>
<!--===============================================================================================-->
<script src="vendor/animsition/js/animsition.min.js"></script>
<!--===============================================================================================-->
<script src="vendor/bootstrap/js/popper.js"></script>
<script src="vendor/bootstrap/js/bootstrap.min.js"></script>
<!--===============================================================================================-->
<script src="vendor/select2/select2.min.js"></script>
<script>
$(".selection-2").select2({
minimumResultsForSearch: 20,
dropdownParent: $('#dropDownSelect1')
});
</script>
<!--===============================================================================================-->
<script src="vendor/daterangepicker/moment.min.js"></script>
<script src="vendor/daterangepicker/daterangepicker.js"></script>
<!--===============================================================================================-->
<script src="vendor/countdowntime/countdowntime.js"></script>
<!--===============================================================================================-->
<script src="js/main_blood.js"></script>
<!-- Global site tag (gtag.js) - Google Analytics -->
<script async src="https://www.googletagmanager.com/gtag/js?id=UA-23581568-13"></script>
<script>
window.dataLayer = window.dataLayer || [];
function gtag(){dataLayer.push(arguments);}
gtag('js', new Date());
gtag('config', 'UA-23581568-13');
</script>
<!--/#footer-->
<script src="js/jquery-2.1.1.js"></script>
<script src="js/jquery.mobile.custom.min.js"></script>
<!-- Resource jQuery -->
<script src="https://ajax.googleapis.com/ajax/libs/jquery/3.4.1/jquery.min.js"></script>
<script src="https://maxcdn.bootstrapcdn.com/bootstrap/3.4.0/js/bootstrap.min.js"></script>
<script src="https://www.gstatic.com/firebasejs/5.9.2/firebase.js"></script>
</body>
</html>