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146 lines (136 loc) · 5.43 KB
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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>Appointment Booking</title>
<style>
body {
font-family: Arial, sans-serif;
margin: 0;
padding: 0;
background-color: #f4f4f4;
}
.container {
max-width: 600px;
margin: 0 auto;
padding: 20px;
background-color: #fff;
border-radius: 8px;
box-shadow: 0 0 10px rgba(0, 0, 0, 0.1);
}
h2 {
text-align: center;
color: #333;
}
label {
font-weight: bold;
}
input[type="text"],
input[type="email"],
input[type="tel"],
input[type="date"],
input[type="time"],
select,
textarea {
width: 100%;
padding: 10px;
margin-bottom: 15px;
border: 1px solid #ccc;
border-radius: 4px;
box-sizing: border-box;
}
input[type="submit"] {
width: 100%;
padding: 10px;
background-color: #4caf50;
color: #fff;
border: none;
border-radius: 4px;
cursor: pointer;
font-size: 16px;
}
input[type="submit"]:hover {
background-color: #45a049;
}
#message {
margin-top: 15px;
padding: 10px;
border-radius: 4px;
}
#message.success {
background-color: #d4edda;
color: #155724;
}
#message.error {
background-color: #f8d7da;
color: #721c24;
}
</style>
</head>
<body>
<div class="container">
<h2>Appointment Booking</h2>
<form id="appointmentForm">
<label for="name">Name:</label><br>
<input type="text" id="name" name="name" required><br>
<label for="email">Email:</label><br>
<input type="email" id="email" name="email" required><br>
<label for="phone">Phone:</label><br>
<input type="tel" id="phone" name="phone" required><br>
<label for="date">Date:</label><br>
<input type="date" id="date" name="date" required><br>
<label for="time">Time:</label><br>
<input type="time" id="time" name="time" required><br>
<label for="service">Service:</label><br>
<select id="service" name="service" required>
<option value="">Select Service</option>
<option value="consultation">Consultation</option>
<option value="checkup">Checkup</option>
<option value="treatment">Treatment</option>
<!-- Add more options as needed -->
</select><br>
<label for="comment">Comment:</label><br>
<textarea id="comment" name="comment"></textarea><br>
<input type="submit" value="Book Appointment">
</form>
<div id="message"></div> <!-- Display success or error message here -->
</div>
<script>
document.getElementById("appointmentForm").addEventListener("submit", function(event) {
event.preventDefault(); // Prevent the form from submitting normally
var formData = new FormData(this); // Get form data
// Send form data via AJAX
var xhr = new XMLHttpRequest();
xhr.open("POST", "appointment_submit.php", true);
xhr.onreadystatechange = function() {
if (xhr.readyState === XMLHttpRequest.DONE) {
if (xhr.status === 200) {
var response = JSON.parse(xhr.responseText);
if (response.messages && response.messages.success) {
// Display success message
document.getElementById("message").className = "success";
document.getElementById("message").innerHTML = response.messages.success;
// Clear the form
document.getElementById("appointmentForm").reset();
} else if (response.messages && response.messages.error) {
// Display error message
document.getElementById("message").className = "error";
document.getElementById("message").innerHTML = response.messages.error;
} else {
// Unknown error occurred
document.getElementById("message").className = "error";
document.getElementById("message").innerHTML = "Unknown error occurred.";
}
} else {
// Request failed
document.getElementById("message").className = "error";
document.getElementById("message").innerHTML = "Error: " + xhr.statusText;
}
}
};
xhr.send(formData); // Send form data
});
</script>
</body>
</html>