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reg_hos.php
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227 lines (150 loc) · 6.62 KB
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<!DOCTYPE html>
<html>
<head>
<title></title>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1">
<link rel="stylesheet" type="text/css" href="css/style.css">
<link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/bootstrap/4.4.1/css/bootstrap.min.css">
<link href="https://fonts.googleapis.com/css?family=Josefin+Sans&display=swap" rel="stylesheet">
</head>
<body>
<nav class="navbar navbar-expand-lg navbar-dark bg-dark">
<a class="navbar-brand" href="index.php">Health Card</a>
<button class="navbar-toggler" type="button" data-toggle="collapse" data-target="#navbarSupportedContent" aria-controls="navbarSupportedContent" aria-expanded="false" aria-label="Toggle navigation">
<span class="navbar-toggler-icon"></span>
</button>
<div class="collapse navbar-collapse" id="navbarSupportedContent">
<ul class="navbar-nav ml-auto">
<li class="nav-item active">
<a class="nav-link" href="index.php">Home <span class="sr-only">(current)</span></a>
</li>
</li>
<li class="nav-item">
<a class="nav-link" href="faq.php">FAQ</a>
</li>
<li class="nav-item">
<a class="nav-link" href="contact.php">Contact Us</a>
</li>
</ul>
<form class="form-inline my-2 my-lg-0">
<input class="form-control mr-sm-2" type="search" placeholder="Search" aria-label="Search">
<button class="btn btn-outline-success my-2 my-sm-0" type="submit">Search</button>
</form>
</div>
</nav>
<script src="https://ajax.googleapis.com/ajax/libs/jquery/3.4.1/jquery.min.js"></script>
<script src="https://cdnjs.cloudflare.com/ajax/libs/popper.js/1.16.0/umd/popper.min.js"></script>
<script src="https://maxcdn.bootstrapcdn.com/bootstrap/4.4.1/js/bootstrap.min.js"></script>
</body>
</html>
<!DOCTYPE html>
<html>
<head>
<title></title>
<link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/bootstrap/4.0.0/css/bootstrap.min.css">
<!-- jQuery library -->
<script src="https://ajax.googleapis.com/ajax/libs/jquery/3.3.1/jquery.min.js"></script>
<!-- Popper JS -->
<script src="https://cdnjs.cloudflare.com/ajax/libs/popper.js/1.12.9/umd/popper.min.js"></script>
<!-- Latest compiled JavaScript -->
<script src="https://maxcdn.bootstrapcdn.com/bootstrap/4.0.0/js/bootstrap.min.js"></script>
</head>
<body>
<h2 class="text-white text-center font-weight-bold bg-success" style="font-size: 55px;">Hospital Enrollment </h2>
<h3 class="text-center">( Detail as per hospital registration ) </h3>
<div class="container"><br>
<div class="col-lg-6 m-auto d-block">
<form action="#" onsubmit="return validation()" class="bg-light">
<div class="form-group">
<label for="user" class="font-weight-bold"> Username: </label>
<input type="text" name="user" class="form-control" id="user" autocomplete="off">
<span id="username" class="text-danger font-weight-bold"> </span>
</div>
<div class="form-group">
<label class="font-weight-bold"> Password: </label>
<input type="text" name="pass" class="form-control" id="pass" autocomplete="off">
<span id="passwords" class="text-danger font-weight-bold"> </span>
</div>
<div class="form-group">
<label class="font-weight-bold"> Confirm Password: </label>
<input type="text" name="conpass" class="form-control" id="conpass" autocomplete="off">
<span id="confrmpass" class="text-danger font-weight-bold"> </span>
</div>
<div class="form-group">
<label class="font-weight-bold"> Mobile Number: </label>
<input type="text" name="mobile" class="form-control" id="mobileNumber" autocomplete="off">
<span id="mobileno" class="text-danger font-weight-bold"> </span>
</div>
<div class="form-group">
<label class="font-weight-bold"> Email: </label>
<input type="text" name="email" class="form-control" id="emails" autocomplete="off">
<span id="emailids" class="text-danger font-weight-bold"> </span>
</div>
<input type="submit" name="submit" value="submit" class="btn btn-success" autocomplete="off">
</form><br><br>
</div>
</div>
<script type="text/javascript">
function validation(){
var user = document.getElementById('user').value;
var pass = document.getElementById('pass').value;
var confirmpass = document.getElementById('conpass').value;
var mobileNumber = document.getElementById('mobileNumber').value;
var emails = document.getElementById('emails').value;
if(user == ""){
document.getElementById('username').innerHTML =" ** Please fill the username field";
return false;
}
if((user.length <= 2) || (user.length > 20)) {
document.getElementById('username').innerHTML =" ** Username lenght must be between 2 and 20";
return false;
}
if(!isNaN(user)){
document.getElementById('username').innerHTML =" ** only characters are allowed";
return false;
}
if(pass == ""){
document.getElementById('passwords').innerHTML =" ** Please fill the password field";
return false;
}
if((pass.length <= 5) || (pass.length > 20)) {
document.getElementById('passwords').innerHTML =" ** Passwords lenght must be between 5 and 20";
return false;
}
if(pass!=confirmpass){
document.getElementById('confrmpass').innerHTML =" ** Password does not match the confirm password";
return false;
}
if(confirmpass == ""){
document.getElementById('confrmpass').innerHTML =" ** Please fill the confirmpassword field";
return false;
}
if(mobileNumber == ""){
document.getElementById('mobileno').innerHTML =" ** Please fill the mobile NUmber field";
return false;
}
if(isNaN(mobileNumber)){
document.getElementById('mobileno').innerHTML =" ** user must write digits only not characters";
return false;
}
if(mobileNumber.length!=10){
document.getElementById('mobileno').innerHTML =" ** Mobile Number must be 10 digits only";
return false;
}
if(emails == ""){
document.getElementById('emailids').innerHTML =" ** Please fill the email idx` field";
return false;
}
if(emails.indexOf('@') <= 0 ){
document.getElementById('emailids').innerHTML =" ** @ Invalid Position";
return false;
}
if((emails.charAt(emails.length-4)!='.') && (emails.charAt(emails.length-3)!='.')){
document.getElementById('emailids').innerHTML =" ** . Invalid Position";
return false;
}
}
</script>
</body>
</html>