the-neighbourhood-health-hub/transfer.html at main · zenowinged/the-neighbourhood-health-hub · GitHub

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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>Transfer - NHHH</title>
    <link rel="stylesheet" href="style.css">
    <link href="https://fonts.googleapis.com/css2?family=Ubuntu:ital,wght@0,300;0,400;0,500;0,700;1,300;1,400;1,500;1,700&display=swap" rel="stylesheet">
</head>
<body>
    <!-- Navbar -->
    <nav class="navbar">
        <ul>
            <li><button class="logo-btn"><a href="homepage.html" style="text-decoration: none; background-color: inherit; color: inherit"><img src="logo.png" alt="logo" class="logo"></a></button></li>
             <li class="right-side"><button class="search-btn">🔍</button></li>
            <li><button class="login-btn">Login</button></li>
            <li><button class="baa-btn"><a href="appointment.html" style="text-decoration: none; background-color: inherit; color: inherit">Book an Appointment</a></button></li>
        </ul>
    </nav>
    <!-- Heading -->
    <div class="main-container">
        <h1 class="page-heading">Switch to Neighborhood Health</h1>

        <!-- Form -->
        <div class="form-box">
            <p class="info-text" style="text-align: center; margin-bottom: 10px;">
                We will handle the call to your old pharmacy. You don't need to do anything else.
            </p>
            <form>
                <label for="name" class="label">Your Name</label>
                <input type="text" class="name" placeholder="Enter your name" required>

                <label class="label">Your Phone Number</label>
                <input type="tel" class="ph-no" placeholder="Enter your number" required>

                <label for="old-pharma" class="label">Name of Old Pharmacy</label>
                <input type="text" class="old-pharma" required>

                <label for="transfer" class="label">Medications to Transfer</label>
                <textarea class="transfer"></textarea>

                <button type="submit" class="submit-btn">Start Transfer</button>
            </form>
        </div>
    </div>
</body>
</html>