-
Notifications
You must be signed in to change notification settings - Fork 0
/
Copy pathvetinfo.html
181 lines (123 loc) · 8.32 KB
/
vetinfo.html
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
<html lang="en">
<head>
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>Pet-Med</title>
<!-- Bootstrap -->
<link href="https://cdn.jsdelivr.net/npm/[email protected]/dist/css/bootstrap.min.css" rel="stylesheet"
integrity="sha384-0evHe/X+R7YkIZDRvuzKMRqM+OrBnVFBL6DOitfPri4tjfHxaWutUpFmBp4vmVor" crossorigin="anonymous">
<!-- Bootstrap Icons -->
<link rel="stylesheet" href="https://cdn.jsdelivr.net/npm/[email protected]/font/bootstrap-icons.css">
<link rel="stylesheet"
href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/4.7.0/css/font-awesome.min.css">
<link rel="stylesheet" href="style.css">
</head>
<body class="green-bg-gradient ">
<div class="modal fade" id="submit" data-bs-backdrop="static" data-bs-keyboard="false" tabindex="-1"
aria-labelledby="submit" aria-hidden="true">
<div class="modal-dialog m-4 mx-sm-auto ">
<div class="modal-content upper-bg rounded-4">
<div class="modal-body text-light text-center mt-3 mb-3 ">
Your information has been recieved by us and once we verify it, you account will be changed into
a vet account.
</div>
<a href="vets.html"
class="button primary-bg text-decoration-none text-dark mx-auto mb-4 rounded-3">Close</a>
</div>
</div>
</div>
<div class="container pt-3">
<div class="row justify-content-center align-items-center pt-3">
<!-- form -->
<div class="card col-10 shadow-lg p-3 m-5 translucent-white rounded-4">
<form>
<div class="container">
<h1 class="primary-text mt-4 text-dark text-center">Enter Vet Information</h1>
<div class="row align-items-center justify-content-center pt-4">
<!-- row1 -->
<div class="col-12 col-md-6 col-lg-4 form-group">
<lable class="form-label" for="fname">First Name</lable>
<input type="text" id="fname" class="form-control mt-2 mb-4 shadow-sm">
</div>
<div class="col-12 col-md-6 col-lg-4 form-group">
<lable class="form-label" for="mname">Middle Name</lable>
<input type="text" id="mname" class="form-control mt-2 mb-4 shadow-sm">
</div>
<div class="col-12 col-md-6 col-lg-4 form-group">
<lable class="form-label" for="lname">Last Name</lable>
<input type="text" id="lname" class="form-control mt-2 mb-4 shadow-sm">
</div>
<!-- row2 -->
<div class="col-6 col-md-4 col-lg-3 form-group">
<lable class="form-label" for="experience">Experience (Yrs)</lable>
<input type="number" id="experience" class="form-control mt-2 mb-4 shadow-sm">
</div>
<div class="col-6 col-md-4 col-lg-3 form-group">
<lable class="form-label" for="dob">DOB</lable>
<input type="date" id="dob" class="form-control mt-2 mb-4 shadow-sm">
</div>
<div class="col-6 col-md-4 col-lg-3 form-group">
<lable class="form-label" for="age">Age</lable>
<input type="number" id="age" class="form-control mt-2 mb-4 shadow-sm">
</div>
<div class="col-6 col-md-4 col-lg-3 form-group">
<lable class="form-label" for="gender">Gender</lable>
<input type="number" id="gender" class="form-control mt-2 mb-4 shadow-sm">
</div>
<div class="col-6 col-md-4 col-lg-3 form-group">
<lable class="form-label" for="speciality">Speciality</lable>
<input type="text" id="speciality" class="form-control mt-2 mb-4 shadow-sm">
</div>
<!-- row3 -->
<div class="col-6 col-md-4 col-lg-3 form-group">
<lable class="form-label" for="timeslot"> Time slot (From)</lable>
<input type="time" id="timeslot" class="form-control mt-2 mb-4 shadow-sm">
</div>
<div class="col-6 col-md-4 col-lg-3 form-group">
<lable class="form-label" for="timeslot"> Time slot (To)</lable>
<input type="time" id="timeslot" class="form-control mt-2 mb-4 shadow-sm">
</div>
<div class="col-6 col-md-4 col-xl-3 form-group">
<lable class="form-label" for="timeslot"> Qualifications</lable>
<input type="text" id="timeslot" class="form-control mt-2 mb-4 shadow-sm">
</div>
<!-- row4 -->
<div class="col-6 col-md-4 col-lg-4 form-group">
<lable class="form-label" for="city">City</lable>
<input type="text" id="city" class="form-control mt-2 mb-4 shadow-sm">
</div>
<div class="col-6 col-md-4 col-lg-4 form-group">
<lable class="form-label" for="state">State</lable>
<input type="text" id="state" class="form-control mt-2 mb-4 shadow-sm">
</div>
<div class="col-12 col-md-4 col-lg-4 form-group">
<lable class="form-label" for="country">Country</lable>
<input type="text" id="country" class="form-control mt-2 mb-4 shadow-sm">
</div>
<!-- row -->
<div class="col-12 col-md-8 col-lg-10 form-group">
<lable class="form-label" for="photo">Photo</lable>
<input type="file" id="photo" class="form-control mt-2 mb-4 shadow-sm">
</div>
<div class="row">
<a href=""
class="button col-8 col-md-4 col-lg-2 fs-5 text-dark rounded-3 my-auto mx-auto mt-4 px-4 mb-3 border-0 text-center"
data-bs-toggle="modal" data-bs-target="#submit">Submit</a>
</div>
</div>
</div>
</form>
</div>
</div>
</div>
<!-- Bootstrap Javascript -->
<script src=" https://cdn.jsdelivr.net/npm/[email protected]/dist/js/bootstrap.bundle.min.js"
integrity="sha384-pprn3073KE6tl6bjs2QrFaJGz5/SUsLqktiwsUTF55Jfv3qYSDhgCecCxMW52nD2" crossorigin="anonymous">
</script>
<script src="https://cdn.jsdelivr.net/npm/@popperjs/[email protected]/dist/umd/popper.min.js"
integrity="sha384-Xe+8cL9oJa6tN/veChSP7q+mnSPaj5Bcu9mPX5F5xIGE0DVittaqT5lorf0EI7Vk"
crossorigin="anonymous"></script>
<script src="https://cdn.jsdelivr.net/npm/[email protected]/dist/js/bootstrap.min.js"
integrity="sha384-kjU+l4N0Yf4ZOJErLsIcvOU2qSb74wXpOhqTvwVx3OElZRweTnQ6d31fXEoRD1Jy"
crossorigin="anonymous"></script>
</body>
</html>