hey im working on a site for a doctor...its a basic site where he can add his patients info and then view it...but for some reason my form wont work here it is:
and here is confirm.php
PHP:
<table width="500" border="0" cellspacing="2" cellpadding="0">
<form action="confirm.php" method="POST">
<tr>
<th style="background-color: #009900;" width="114" scope="col">Field</th>
<th style="background-color: #666666;" width="386" scope="col">Input</th>
</tr>
<tr>
<td class="style">Date</td>
<td class="style1"><? $date = date("Y-m-j"); echo"$date"; ?></td>
</tr>
<tr>
<td class="style">Number</td>
<td class="style1"><input type="text" name="number"></td>
</tr>
<tr>
<td class="style">Balance</td>
<td class="style1"><input type="text" name="balance"></td>
</tr>
<tr>
<td class="style">Name</td>
<td class="style1"><input type="text" name="name"></td>
</tr>
<tr>
<td class="style">Date of Birth </td>
<td class="style1"><input type="text" name="dob"></td>
</tr>
<tr>
<td class="style">Address</td>
<td class="style1"><input type="text" name="address"></td>
</tr>
<tr>
<td class="style">Diagnosis</td>
<td class="style1"><input type="text" name="textfield"></td>
</tr>
<tr>
<td class="style">Site of Injection </td>
<td class="style1"><input type="text" name="sij"></td>
</tr>
<tr>
<td class="style">ย </td>
<td class="style1"><input type="button" name="submit" value="Submit"> ย </td>
</tr>
</form>
</table>
and here is confirm.php
PHP:
<?
if($_POST['submit']) {
$connect = mysql_connect("localhost","******","***")or die(mysql_error());
mysql_select_db("****")or die(mysql_error());
$date = date("Y-m-j");
$number = $_POST['number'];
$balance = $_POST['balance'];
$name = $_POST['name'];
$dob = $_POST['dob'];
$address = $_POST['address'];
$diagnosis = $_POST['diagnosis'];
$sij = $_POST['sij'];
$result="INSERT INTO morphine (date,number,balance,name,dob,address,diagnosis,sij)".
"VALUES ( '$date', '$number', '$balance', '$name', '$dob', '$address', $diagnosis', '$sij')") or die(mysql_error("Could not Send Items"));
$rows=mysql_num_rows($result);
if(mysql_query($result, $connec) {
echo "Data Entered into the Database";
}
else
{
echo"sorry, your data was not stored";
}
?>




