ikan Uploader :
Directory : /var/www/html/shardahospital.org/drbooking/application/views/
Upload File : |
| Current File : /var/www/html/shardahospital.org/drbooking/application/views/feedback.php |
<?php $userData = $this->session->userdata('user_data'); ?>
<div class="doctor-detail">
<div class="container">
<div class="row">
<div class="col-md-8">
<?php if($this->session->flashdata('msg')){ ?>
<p class="alert alert-success"><?=$this->session->flashdata('msg')?></p>
<?php } ?>
<form method="post" name="feedbak" action="<?=base_url('user/feedback')?>">
<div class="drb-leftbar">
<h1>Feedback </h1>
<div class="feebbackform">
<div class="feedback-in">
<input type="text" id="full_name" name="full_name" value="<?=$userData->full_name?>" maxlength="100" placeholder="Name" required>
</div>
<div class="feedback-in">
<input type="email" id="email_id" name="email_id" value="<?=$userData->email_id?>" maxlength="100" placeholder="Email ID" required>
</div>
<div class="feedback-in">
<input type="text" id="contact_no" name="contact_no" value="<?=$userData->mob?>" maxlength="10" placeholder="Phone No" required>
</div>
<div class="feedback-in">
<textarea name="message" id="message" placeholder="Your Feedback" required></textarea>
</div>
<div class="radio-btn">
<span style="color:red;">*All Fileds are mandatory</span>
</div>
<div class="feedback-in">
<input type="submit" name="submit" id="submit" value="Submit" />
</div>
</div>
</div>
</form>
</div>
<div class="col-md-4">
<?php include('_parts/lhs_part.php')?>
</div>
</div>
</div>
</div>
</div>
Kontol Shell Bypass