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add-patient.php
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<?php
include "./dbcon.php";
if (isset($_POST['submit'])) {
$name = $_POST['name'];
$surname = $_POST['surname'];
$id_number = $_POST['id_number'];
$phone = $_POST['phone'];
$email = $_POST['email'];
$department = $_POST['department'];
mysqli_query($dbcon, "insert into `patients` (name,surname,id_number,phone,email,department) values('$name','$surname','$id_number','$phone','$email','$department')");
} ?>
<!DOCTYPE html>
<html lang="en">
<head>
<!--Meta-->
<meta charset="UTF-8" />
<meta http-equiv="X-UA-Compatible" content="IE=edge" />
<meta name="viewport" content="width=device-width, initial-scale=1.0" />
<title>Add Patient</title>
<link rel="icon" type="image/x-icon" href="https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcQhOOn89h2oC2mX4CubFI1t2B2ftiUldDH5sHC9BFxd9g&s" />
<!--Bootstrap-->
<link href="https://cdn.jsdelivr.net/npm/bootstrap@5.3.0/dist/css/bootstrap.min.css" rel="stylesheet" />
<script src="https://cdn.jsdelivr.net/npm/bootstrap@5.3.0/dist/js/bootstrap.bundle.min.js"></script>
</head>
<body>
<?php include './header.php'; ?>
<!--Appointment-->
<section class="container mt-3 row m-auto p-0">
<!--Input-->
<form method="post" class=" p-0 col d-flex flex-column align-items-center justify-content-center">
<div class="w-100 bg-light -10 rounded-4 p-4">
<!--Personal-->
<h5>Add Patient</h5>
<div class="input-group mb-2">
<div class="input-group-prepend">
<div class="input-group-text">ID Number</div>
</div>
<input type="text" maxlength="11" class="form-control" id="IdInput" name="id_number" required />
</div>
<div class="input-group mb-2">
<div class="input-group-prepend">
<div class="input-group-text">Name</div>
</div>
<input type="numeric" class="form-control" id="NameInput" name="name" required />
</div>
<div class="input-group mb-2">
<div class="input-group-prepend">
<div class="input-group-text">Surname</div>
</div>
<input type="text" class="form-control" id="SurnameInput" name="surname" required />
</div>
<div class="input-group mb-2">
<div class="input-group-prepend">
<div class="input-group-text">E-mail</div>
</div>
<input type="numeric" class="form-control" id="EmailInput" name="email" required />
</div>
<div class="input-group mb-2">
<div class="input-group-prepend">
<div class="input-group-text">Phone</div>
</div>
<input type="text" class="form-control" id="PhoneInput" name="phone" required />
</div>
<div class="input-group mb-2">
<div class="input-group-prepend">
<div class="input-group-text">Department</div>
</div>
<select class="form-control" id="DepartmentInput" name="department" placeholder="Choose Department" required>
<option disabled selected hidden></option>
<option>Oral and Dental Diseases</option>
<option>Eye Diesases</option>
<option>Ear, Nose and Throat Diseases</option>
<option>General Surgery</option>
<option>Plastic Surgery</option>
</select>
</div>
<!--Button-->
<div class="d-flex gap-2 mt-3">
<button class="btn btn-danger w-100 rounded-3 " type="reset">Clear the Form</button>
<button class="btn btn-success w-100 rounded-3 text-light" name="submit" type="submit">Add Patient
</button>
</div>
</div>
</form>
<!--Animation-->
<div class="col d-flex align-items-center justify-content-center">
<script src="https://unpkg.com/@lottiefiles/lottie-player@latest/dist/lottie-player.js"></script>
<lottie-player src="https://assets7.lottiefiles.com/packages/lf20_x1gjdldd.json" mode="bounce" background="transparent" speed="0.6" style="width: fit-content; height: fit-content" loop autoplay>
</lottie-player>
</div>
</section>
<!--JS-->
<script>
if (window.history.replaceState) {
window.history.replaceState(null, null, window.location.href);
}
</script>
</body>
</html>