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addDoctor.php
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<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">
<title>Medical Center | Add New Doctor</title>
<!-- Favicon -->
<link rel="shortcut icon" href="assets/img/favicon.png" type="image/x-icon">
<!-- Font awesome -->
<link href="assets/css/font-awesome.css" rel="stylesheet">
<!-- Bootstrap -->
<link href="assets/css/bootstrap.css" rel="stylesheet">
<!-- Slick slider -->
<link rel="stylesheet" type="text/css" href="assets/css/slick.css">
<!-- Fancybox slider -->
<link rel="stylesheet" href="assets/css/jquery.fancybox.css" type="text/css" media="screen" />
<!-- Theme color -->
<link id="switcher" href="assets/css/theme-color/default-theme.css" rel="stylesheet">
<!-- Main style sheet -->
<link href="assets/css/style.css" rel="stylesheet">
<!-- Google Fonts -->
<link href='https://fonts.googleapis.com/css?family=Montserrat:400,700' rel='stylesheet' type='text/css'>
<link href='https://fonts.googleapis.com/css?family=Roboto:400,400italic,300,300italic,500,700' rel='stylesheet' type='text/css'>
</head>
<body>
<!--START SCROLL TOP BUTTON -->
<a class="scrollToTop" href="#">
<i class="fa fa-angle-up"></i>
</a>
<!-- END SCROLL TOP BUTTON -->
<!-- Start menu -->
<section id="mu-menu">
<nav class="navbar navbar-default" role="navigation">
<div class="container">
<div class="navbar-header">
<!-- FOR MOBILE VIEW COLLAPSED BUTTON -->
<button type="button" class="navbar-toggle collapsed" data-toggle="collapse" data-target="#navbar" aria-expanded="false" aria-controls="navbar">
<span class="sr-only">Toggle navigation</span>
<span class="icon-bar"></span>
<span class="icon-bar"></span>
<span class="icon-bar"></span>
</button>
<!-- LOGO -->
<!-- TEXT BASED LOGO -->
<a class="navbar-brand" href="index.html"><i class="fa fa-university"></i><span>Medico</span></a>
<!-- IMG BASED LOGO -->
<!-- <a class="navbar-brand" href="index.html"><img src="assets/img/logo.png" alt="logo"></a> -->
</div>
<div id="navbar" class="navbar-collapse collapse">
<ul id="top-menu" class="nav navbar-nav navbar-right main-nav">
<!-- <li ><a href="index.html">Home</a></li> -->
<li><a href="index.html#mu-about-us">Medicines</a></li>
<li><a href="index.html#mu-our-teacher">Ambulances</a></li>
<!-- <li><a href="sign-in.html">Sign In</a></li> -->
<li class="active"><a href="#">Doctors</a></li>
<li><a href="#" id="mu-search-icon"><i class="fa fa-search"></i></a></li>
</ul>
</div><!--/.nav-collapse -->
</div>
</nav>
</section>
<!-- End menu -->
<!-- Start search box -->
<div id="mu-search">
<div class="mu-search-area">
<button class="mu-search-close"><span class="fa fa-close"></span></button>
<div class="container">
<div class="row">
<div class="col-md-12">
<form class="mu-search-form">
<input type="search" placeholder="Type Your Keyword(s) & Hit Enter">
</form>
</div>
</div>
</div>
</div>
</div>
<!-- End search box -->
<!-- Page breadcrumb -->
<section id="mu-page-breadcrumb">
<div class="container">
<div class="row">
<div class="col-md-12">
<div class="mu-page-breadcrumb-area">
<h2>Create New Doctor Profile</h2>
</div>
</div>
</div>
</div>
</section>
<!-- End breadcrumb -->
<?php $r="kav";?>
<!-- Start contact -->
<section id="mu-contact">
<div class="container">
<div class="row">
<div class="col-md-12">
<div class="mu-contact-area">
<!-- start contact content -->
<div class="mu-contact-content">
<div class="row">
<div class="col-md-6">
<div class="mu-contact-left">
<form class="contactform" action="insertDoctor.php" method="post">
<p class="comment-form-author">
<label for="author">First name <span class="required">*</span></label>
<input type="text" required="required" size="30" value="<?php echo $r;?>" name="first_name">
</p>
<p class="comment-form-author">
<label for="author">Last name <span class="required">*</span></label>
<input type="text" required="required" size="30" value="" name="last_name">
</p>
<p class="comment-form-author">
<label for="author">Speciality <span class="required">*</span></label>
<input type="text" required="required" size="30" value="" name="speciality">
</p>
<p><label for="author">District </span></label>
<select name="district" class="district1">
<option value="Colombo">Colombo</option>
<option value="Kandy">Kandy</option>
<option value="Gampaha">Gampaha</option>
<option value="Galle">Galle</option>
<option value="Kathuthara">Kaluthara</option>
</select></p><br>
<p class="comment-form-author">
<label for="author">Qualifications <span class="required">*</span></label>
<input type="text" required="required" size="30" value="" name="qualifications">
</p>
<p class="comment-form-author">
<label for="author">Reg No: <span class="required">*</span></label>
<input type="text" required="required" size="30" value="" name="regno">
</p>
<div>
<span data-type="radio" data-name="gender_wrapper" id="u_0_13">
<span class="_5k_2 _5dba">
<input type="radio" name="sex" value="Female" id="u_0_9">
<label class="_58mt" for="u_0_9">Female</label>
</span>
<span>
<input type="radio" name="sex" value="Male" id="u_0_a">
<label class="_58mt" for="u_0_a">Male</label>
</span>
</span>
</div>
<br>
<div class="_58mq _5dbb" id="u_0_10"><div class="mtm mbs _2_68">Birthday</div><div class="_5k_5"><span class="_5k_4" data-type="selectors" data-name="birthday_wrapper" id="u_0_11"><span><select aria-label="Day" name="birthday_day" id="day" title="Day" class="_5dba"><option value="0">Day</option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option><option value="7">7</option><option value="8">8</option><option value="9">9</option><option value="10">10</option><option value="11">11</option><option value="12" selected="1">12</option><option value="13">13</option><option value="14">14</option><option value="15">15</option><option value="16">16</option><option value="17">17</option><option value="18">18</option><option value="19">19</option><option value="20">20</option><option value="21">21</option><option value="22">22</option><option value="23">23</option><option value="24">24</option><option value="25">25</option><option value="26">26</option><option value="27">27</option><option value="28">28</option><option value="29">29</option><option value="30">30</option><option value="31">31</option></select><select aria-label="Month" name="birthday_month" id="month" title="Month" class="_5dba"><option value="0">Month</option><option value="1">Jan</option><option value="2">Feb</option><option value="3" selected="1">Mar</option><option value="4">Apr</option><option value="5">May</option><option value="6">Jun</option><option value="7">Jul</option><option value="8">Aug</option><option value="9">Sept</option><option value="10">Oct</option><option value="11">Nov</option><option value="12">Dec</option></select><select aria-label="Year" name="birthday_year" id="year" title="Year" class="_5dba"><option value="0">Year</option><option value="2019">2019</option><option value="2018">2018</option><option value="2017">2017</option><option value="2016">2016</option><option value="2015">2015</option><option value="2014">2014</option><option value="2013">2013</option><option value="2012">2012</option><option value="2011">2011</option><option value="2010">2010</option><option value="2009">2009</option><option value="2008">2008</option><option value="2007">2007</option><option value="2006">2006</option><option value="2005">2005</option><option value="2004">2004</option><option value="2003">2003</option><option value="2002">2002</option><option value="2001">2001</option><option value="2000">2000</option><option value="1999">1999</option><option value="1998">1998</option><option value="1997">1997</option><option value="1996">1996</option><option value="1995">1995</option><option value="1994" selected="1">1994</option><option value="1993">1993</option><option value="1992">1992</option><option value="1991">1991</option><option value="1990">1990</option><option value="1989">1989</option><option value="1988">1988</option><option value="1987">1987</option><option value="1986">1986</option><option value="1985">1985</option><option value="1984">1984</option><option value="1983">1983</option><option value="1982">1982</option><option value="1981">1981</option><option value="1980">1980</option><option value="1979">1979</option><option value="1978">1978</option><option value="1977">1977</option><option value="1976">1976</option><option value="1975">1975</option><option value="1974">1974</option><option value="1973">1973</option><option value="1972">1972</option><option value="1971">1971</option><option value="1970">1970</option><option value="1969">1969</option><option value="1968">1968</option><option value="1967">1967</option><option value="1966">1966</option><option value="1965">1965</option><option value="1964">1964</option><option value="1963">1963</option><option value="1962">1962</option><option value="1961">1961</option><option value="1960">1960</option><option value="1959">1959</option><option value="1958">1958</option><option value="1957">1957</option><option value="1956">1956</option><option value="1955">1955</option><option value="1954">1954</option><option value="1953">1953</option><option value="1952">1952</option><option value="1951">1951</option><option value="1950">1950</option><option value="1949">1949</option><option value="1948">1948</option><option value="1947">1947</option><option value="1946">1946</option><option value="1945">1945</option><option value="1944">1944</option><option value="1943">1943</option><option value="1942">1942</option><option value="1941">1941</option><option value="1940">1940</option><option value="1939">1939</option><option value="1938">1938</option><option value="1937">1937</option><option value="1936">1936</option><option value="1935">1935</option><option value="1934">1934</option><option value="1933">1933</option><option value="1932">1932</option><option value="1931">1931</option><option value="1930">1930</option><option value="1929">1929</option><option value="1928">1928</option><option value="1927">1927</option><option value="1926">1926</option><option value="1925">1925</option><option value="1924">1924</option><option value="1923">1923</option><option value="1922">1922</option><option value="1921">1921</option><option value="1920">1920</option><option value="1919">1919</option><option value="1918">1918</option><option value="1917">1917</option><option value="1916">1916</option><option value="1915">1915</option><option value="1914">1914</option><option value="1913">1913</option><option value="1912">1912</option><option value="1911">1911</option><option value="1910">1910</option><option value="1909">1909</option><option value="1908">1908</option><option value="1907">1907</option><option value="1906">1906</option><option value="1905">1905</option></select></span></span><i class="_5dbc _5k_6 img sp_6E_d5dmi7E6 sx_f40ac8"></i><i class="_5dbd _5k_7 img sp_6E_d5dmi7E6 sx_df456a"></i><div class="_1pc_"></div></div></div>
<br>
<p class="form-submit">
<input type="submit" value="Submit" class="mu-post-btn" name="submit">
</p>
</form>
</div>
</div>
<div class="col-md-6">
<div class="mu-contact-right">
<div>
<img src="./assets/img/favicon.png" class="image1"/>
</div>
</div>
</div>
</div>
</div>
<!-- end contact content -->
</div>
</div>
</div>
</div>
</section>
<!-- End contact -->
<!-- Start footer -->
<footer id="mu-footer">
<!-- start footer bottom -->
<div class="mu-footer-bottom">
<div class="container">
<div class="mu-footer-bottom-area">
<p>Designed by <a rel="nofollow">Team KAT</a></p>
</div>
</div>
</div>
<!-- end footer bottom -->
</footer>
<!-- End footer -->
<!-- jQuery library -->
<script src="assets/js/jquery.min.js"></script>
<!-- Include all compiled plugins (below), or include individual files as needed -->
<script src="assets/js/bootstrap.js"></script>
<!-- Slick slider -->
<script type="text/javascript" src="assets/js/slick.js"></script>
<!-- Counter -->
<script type="text/javascript" src="assets/js/waypoints.js"></script>
<script type="text/javascript" src="assets/js/jquery.counterup.js"></script>
<!-- Mixit slider -->
<script type="text/javascript" src="assets/js/jquery.mixitup.js"></script>
<!-- Add fancyBox -->
<script type="text/javascript" src="assets/js/jquery.fancybox.pack.js"></script>
<!-- Custom js -->
<script src="assets/js/custom.js"></script>
</body>
</html>