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register.php
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register.php
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<!doctype html>
<html lang="zxx">
<head>
<!-- Required meta tags -->
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1, shrink-to-fit=no">
<title>Drug Rial | Customer</title>
<link rel="icon" href="img/favicon.png">
<!-- Bootstrap CSS -->
<link rel="stylesheet" href="css/bootstrap.min.css">
<!-- animate CSS -->
<link rel="stylesheet" href="css/animate.css">
<!-- owl carousel CSS -->
<link rel="stylesheet" href="css/owl.carousel.min.css">
<!-- font awesome CSS -->
<link rel="stylesheet" href="css/all.css">
<!-- flaticon CSS -->
<link rel="stylesheet" href="css/flaticon.css">
<link rel="stylesheet" href="css/themify-icons.css">
<!-- font awesome CSS -->
<link rel="stylesheet" href="css/magnific-popup.css">
<!-- swiper CSS -->
<link rel="stylesheet" href="css/slick.css">
<!-- style CSS -->
<link rel="stylesheet" href="css/style.css">
</head>
<body style="background-image: url(img/7de965ddeefc07fbdfb012a09caab478.jpg);background-repeat: no-repeat;background-size: 100vw 800px;">
<section class="vh-100 gradient-custom">
<div class="container py-5 h-120">
<div class="row justify-content-center align-items-center h-100">
<div class="col-20 col-lg-10 col-xl-7">
<div class="card shadow-2-strong card-registration" style="border-radius: 15px;background-color: #00000085;">
<div class="text-center mt-5">
<img src="img/lg.png" style="width: 185px;" alt="logo">
</div>
<div class="card-body p-4 p-md-5 ">
<h3 class="mb-4 pb-2 pb-md-0 mb-md-5 text-light">Registration Form</h3>
<form class="row contact_form d-flex justify-content-center" action="controller/register.php" method="post" >
<div class="row " >
<div class="col-md-6 mb-4">
<div class="form-outline">
<label class="form-label text-light" for="firstName"> Name</label>
<input type="text" name="name" class="form-control form-control-lg" placeholder="Name" required />
</div>
</div>
<div class="col-md-6 mb-4">
<div class="form-outline">
<label class="form-label text-light" for="lastName">Email</label>
<input type="email" name="email" class="form-control form-control-lg" placeholder="Email" required/>
</div>
</div>
</div>
<div class="row">
<div class="col-md-6 mb-4 d-flex align-items-center">
<div class="form-outline datepicker w-100">
<label for="birthdayDate" class="form-label text-light">Password</label>
<input type="password" name="password" class="form-control form-control-lg" placeholder="Password" required />
</div>
</div>
<div class="col-md-6 mb-4">
<h6 class="mb-2 pb-1 text-light">Gender: </h6>
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" name="gender" id="femaleGender"
value="female" checked required />
<label class="form-check-label text-light" for="femaleGender">Female</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" name="gender" id="maleGender"
value="male" required/>
<label class="form-check-label text-light" for="maleGender">Male</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" name="gender" id="otherGender"
value="others" required/>
<label class="form-check-label text-light" for="otherGender">Other</label>
</div>
</div>
</div>
<div class="row">
<div class="col-md-6 mb-4 pb-2">
<div class="form-outline">
<label class="form-label text-light" >Age</label>
<input type="number" name="age" class="form-control form-control-lg" placeholder="Age" required />
</div>
</div>
<div class="col-md-6 mb-4 pb-2">
<div class="form-outline">
<label class="form-label text-light" for="phoneNumber">Phone Number</label>
<input type="tel" name="phone" class="form-control form-control-lg" placeholder="Phone Number" required/>
</div>
</div>
</div>
<div class="row">
<div class="col-md-6 mb-4 pb-2">
<div class="form-outline">
<label class="form-label text-light" >Address</label>
<input type="text" name="address" class="form-control form-control-lg" placeholder="Address" required />
</div>
</div>
<div class="col-md-6 mb-4 pb-2">
<div class="form-outline">
<label class="form-label text-light" >City</label>
<input type="text" name="city" class="form-control form-control-lg" placeholder="city"/>
</div>
</div>
</div>
<div class="row">
<div class="col-md-6 mb-4 pb-2">
<div class="form-outline">
<label class="form-label text-light" >Pin Code</label>
<input type="number" name="pincode" class="form-control form-control-lg" placeholder="Pin Code" />
</div>
</div>
<div class="col-md-6 mb-4 pb-2">
<div class="form-outline">
<label class="form-label text-light" for="phoneNumber">State</label>
<input type="tel" name="state" class="form-control form-control-lg"placeholder="State" required/>
</div>
</div>
</div>
<button type="submit" value="submit" name="sgn" class="btn btn-primary w-100 p-3 fw-bolder">
Sign Up
</button>
</form>
</div>
</div>
</div>
</div>
</div>
</section>
<!--================login_part end =================-->
<!--::footer_part start::-->
<!--::footer_part end::-->
<!-- jquery plugins here-->
<script src="js/jquery-1.12.1.min.js"></script>
<!-- popper js -->
<script src="js/popper.min.js"></script>
<!-- bootstrap js -->
<script src="js/bootstrap.min.js"></script>
<!-- easing js -->
<script src="js/jquery.magnific-popup.js"></script>
<!-- swiper js -->
<script src="js/swiper.min.js"></script>
<!-- swiper js -->
<script src="js/mixitup.min.js"></script>
<!-- particles js -->
<script src="js/owl.carousel.min.js"></script>
<script src="js/jquery.nice-select.min.js"></script>
<!-- slick js -->
<script src="js/slick.min.js"></script>
<script src="js/jquery.counterup.min.js"></script>
<script src="js/waypoints.min.js"></script>
<script src="js/contact.js"></script>
<script src="js/jquery.ajaxchimp.min.js"></script>
<script src="js/jquery.form.js"></script>
<script src="js/jquery.validate.min.js"></script>
<script src="js/mail-script.js"></script>
<!-- custom js -->
<script src="js/custom.js"></script>
</body>
</html>