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Viewing / Editing File: enquiry - ADD- MORE.php

<?php 
  include("header.php");
?>
<script src="js/jquery-1.11.1.min.js"></script>

<script type="text/javascript">
 
 $(document).ready(function(){
            // Add more
            $('#addmore').click(function(){

// Get last id 
                var lastname_id = $('.tr_input input[type=file]:nth-child(1)').last().attr('id');
                var split_id = lastname_id.split('_');

// New index
                var index = Number(split_id[1]) + 1;
                // Create row with input elements
var html = "<div class='tr_input'><input type='file' class='username'  id='testcode_"+index+"' name='price[]' style=''><div class='col-lg-1 col-md-1 col-sm-1 col-xs-1' style=''><a href='javascript:void(0);' id='remove_field'  class='remCF btn btn-info' >-</a></div></div>";
                // Append data
                $('#tab').append(html);
            });
      
           $("#tab").on('click','.remCF',function(){
        $(this).parent().parent().remove();

});
        });
  $(document).ready(function(){
            // Add more
            $('#addmore').click(function(){
        
        
      });
      
  }); 
</script>

<div class="enquiry">
  <div class="spec aos-init aos-animate" data-aos="fade-down" style="transition:all 1500ms ease-in-out">
    <h2>Enquiry Form</h2>
  </div>
      
    <div class="container">
        <div class="col-md-3"></div>
        <div class="col-md-6 contact-left">
              <form action="#" method="post">

<div class="form-left">
                        <label style="color: #FFF;font-weight: bold;">Patient Name:</label>
                        <input type="text" placeholder="Patient Name" name="na" required="">
                      </div>
                      <div class="form-right">
                        <label style="color: #FFF;font-weight: bold;">Patient Phone no :</label>
                        <input type="text" placeholder="Patient Phone No" name="phn" required="">
                      </div>
                      <div class="form-rightt">
                        <label style="color: #FFF;font-weight: bold;">Sex :</label> 
                          <input type="radio" name="gender" value="male" checked> Male
                          <input type="radio" name="gender" value="female"> Female
                          <input type="radio" name="gender" value="other"> Other
                      </div>                    
                      <div class="form-left">
                        <label style="color: #FFF;font-weight: bold;">Patient Date of Birth :</label>
                        <input type="text" id="datepicker5" name="dob" placeholder="Enter Date of Birth"  />
                      </div>  
                      <div class="form-right">
                        <label style="color: #FFF;font-weight: bold;">Patient file Upload:</label>
                        <div class='tr_input' id="tab">
                          <input type='file' class='username'  id='testcode_1' name="price[]" style="">
                          <input type='button' class="btn btn-info" value='+' id='addmore' >
                        </div>
                      </div>
                      <div class="form-left">
                        <label style="color: #FFF;font-weight: bold;">Doctor Name :</label> 
                        <input type="text" name="pro_name" value="Doctor :( PRODUCT100 )" placeholder="Enter doctor Name" readonly="">
                      </div>
                      <label style="color: #FFF;font-weight: bold;">Description :</label> 
                      <textarea name="msg" placeholder="Enter Your Message" required=""></textarea>                      
                    <input type="submit" value="Submit">
              </form> 
        </div>
        <div class="col-md-3"></div>
    </div>
</div>

<?php 
include("footer.php");
?>

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