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sign-up.html
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sign-up.html
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<!doctype html>
<html class="no-js" lang="zxx">
<head>
<!-- Meta Tags -->
<meta charset="utf-8">
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<meta name="keywords" content="Site keywords here">
<meta name="description" content="">
<meta name='copyright' content=''>
<meta name="viewport" content="width=device-width, initial-scale=1, shrink-to-fit=no">
<!-- Title -->
<title>TrustMed - Where Trust meets Medication.</title>
<!-- Favicon -->
<link rel="icon" href="img/favicon.png">
<!-- Google Fonts -->
<link href="https://fonts.googleapis.com/css?family=Poppins:200i,300,300i,400,400i,500,500i,600,600i,700,700i,800,800i,900,900i&display=swap" rel="stylesheet">
<!-- Bootstrap CSS -->
<link rel="stylesheet" href="css/bootstrap.min.css">
<!-- Nice Select CSS -->
<link rel="stylesheet" href="css/nice-select.css">
<!-- Font Awesome CSS -->
<link rel="stylesheet" href="css/font-awesome.min.css">
<!-- icofont CSS -->
<link rel="stylesheet" href="css/icofont.css">
<!-- Slicknav -->
<link rel="stylesheet" href="css/slicknav.min.css">
<!-- Owl Carousel CSS -->
<link rel="stylesheet" href="css/owl-carousel.css">
<!-- Datepicker CSS -->
<link rel="stylesheet" href="css/datepicker.css">
<!-- Animate CSS -->
<link rel="stylesheet" href="css/animate.min.css">
<!-- Magnific Popup CSS -->
<link rel="stylesheet" href="css/magnific-popup.css">
<!-- Medipro CSS -->
<link rel="stylesheet" href="css/normalize.css">
<link rel="stylesheet" href="style.css">
<link rel="stylesheet" href="css/responsive.css">
</head>
<body>
<!-- Preloader -->
<div class="preloader">
<div class="loader">
<div class="loader-outter"></div>
<div class="loader-inner"></div>
<div class="indicator">
<svg width="16px" height="12px">
<polyline id="back" points="1 6 4 6 6 11 10 1 12 6 15 6"></polyline>
<polyline id="front" points="1 6 4 6 6 11 10 1 12 6 15 6"></polyline>
</svg>
</div>
</div>
</div>
<!-- End Preloader -->
<!-- Header Area -->
<header class="header" >
<!-- Topbar -->
<div class="topbar">
<div class="container">
<div class="row">
<div class="col-lg-6 col-md-5 col-12">
<!-- Contact -->
<ul class="top-link">
<li><a href="#">About</a></li>
<li><a href="#">Doctors</a></li>
<li><a href="#">Contact</a></li>
<li><a href="#">FAQ</a></li>
</ul>
<!-- End Contact -->
</div>
<div class="col-lg-6 col-md-7 col-12">
<!-- Top Contact -->
<ul class="top-contact">
<li><i class="fa fa-phone"></i>+880 1234 56789</li>
<li><i class="fa fa-envelope"></i><a href="mailto:support@yourmail.com">support@yourmail.com</a></li>
</ul>
<!-- End Top Contact -->
</div>
</div>
</div>
</div>
<!-- End Topbar -->
<!-- Header Inner -->
<div class="header-inner">
<div class="container">
<div class="inner">
<div class="row">
<div class="col-lg-3 col-md-3 col-12">
<!-- Start Logo -->
<div class="logo">
<a href="index.html"><img src="img/logo.png" alt="#"></a>
</div>
<!-- End Logo -->
<!-- Mobile Nav -->
<div class="mobile-nav"></div>
<!-- End Mobile Nav -->
</div>
<div class="col-lg-7 col-md-9 col-12">
<!-- Main Menu -->
<div class="main-menu">
<nav class="navigation">
<ul class="nav menu">
<li class="active"><a href="#">Home <i class="icofont-rounded-down"></i></a>
<ul class="dropdown">
<li><a href="index.html">Home Page 1</a></li>
</ul>
</li>
<li><a href="#">Doctos </a></li>
<li><a href="#">Services </a></li>
<li><a href="#">Pages <i class="icofont-rounded-down"></i></a>
<ul class="dropdown">
<li><a href="404.html">404 Error</a></li>
</ul>
</li>
<li><a href="#">Blogs <i class="icofont-rounded-down"></i></a>
<ul class="dropdown">
<li><a href="blog-single.html">Blog Details</a></li>
</ul>
</li>
<li><a href="contact.html">Contact Us</a></li>
</ul>
</nav>
</div>
<!--/ End Main Menu -->
</div>
<div class="col-lg-2 col-12">
<div class="get-quote">
<a href="appointment.html" class="btn">Book Appointment</a>
</div>
</div>
</div>
</div>
</div>
</div>
<!--/ End Header Inner -->
</header>
<!-- End Header Area -->
<!-- Breadcrumbs -->
<div class="breadcrumbs overlay">
<div class="container">
<div class="bread-inner">
<div class="row">
<div class="col-12">
<h2>Contact Us</h2>
<ul class="bread-list">
<li><a href="index.html">Home</a></li>
<li><i class="icofont-simple-right"></i></li>
<li class="active">Contact Us</li>
</ul>
</div>
</div>
</div>
</div>
</div>
<!-- End Breadcrumbs -->
<!-- Start Contact Us -->
<section class="contact-us section">
<div class="container">
<div class="inner">
<div class="row">
<div class="col-lg-6">
<div class="contact-us-form">
<h2>Contact With Us</h2>
<p>If you have any questions please fell free to contact with us.</p>
<!-- Form -->
<form class="form" method="post" action="mail/mail.php">
<div class="background">
<div class="blur-overlay">
<div class="signup-container">
<h2>Patient Sign-Up</h2>
<form id="signup-form" onsubmit="return validateForm()">
<div class="form-group">
<label for="name">Name:</label>
<input type="text" id="name" name="name" required>
</div>
<div class="form-group">
<label for="email">Email:</label>
<input type="email" id="email" name="email" required>
</div>
<div class="form-group">
<label for="mobile">Mobile Number:</label>
<input type="text" id="mobile" name="mobile" required>
</div>
<div class="form-group">
<label for="password">Set Password:</label>
<input type="password" id="password" name="password" required>
</div>
<button type="submit">Sign Up</button>
</form>
</div>
</div>
</div>
<script src="script.js"></script>
</form>
<!--/ End Form -->
</div>
</div>
</div>
</div>
<div class="contact-info">
<div class="row">
<!-- single-info -->
<div class="col-lg-4 col-12 ">
<div class="single-info">
<i class="icofont icofont-ui-call"></i>
<div class="content">
<h3>+(000) 1234 56789</h3>
<p>info@company.com</p>
</div>
</div>
</div>
<!--/End single-info -->
<!-- single-info -->
<div class="col-lg-4 col-12 ">
<div class="single-info">
<i class="icofont-google-map"></i>
<div class="content">
<h3>2 Fir e Brigade Road</h3>
<p>Chittagonj, Lakshmi Nagar</p>
</div>
</div>
</div>
<!--/End single-info -->
<!-- single-info -->
<div class="col-lg-4 col-12 ">
<div class="single-info">
<i class="icofont icofont-wall-clock"></i>
<div class="content">
<h3>Open 24/7</h3>
</div>
</div>
</div>
<!--/End single-info -->
</div>
</div>
</div>
</section>
<!--/ End Contact Us -->
<!-- Footer Area -->
<footer id="footer" class="footer ">
<!-- Footer Top -->
<div class="footer-top">
<div class="container">
<div class="row">
<div class="col-lg-3 col-md-6 col-12">
<div class="single-footer">
<h2>About Us</h2>
<p>Lorem ipsum dolor sit am consectetur adipisicing elit do eiusmod tempor incididunt ut labore dolore magna.</p>
<!-- Social -->
<ul class="social">
<li><a href="#"><i class="icofont-facebook"></i></a></li>
<li><a href="#"><i class="icofont-google-plus"></i></a></li>
<li><a href="#"><i class="icofont-twitter"></i></a></li>
<li><a href="#"><i class="icofont-vimeo"></i></a></li>
<li><a href="#"><i class="icofont-pinterest"></i></a></li>
</ul>
<!-- End Social -->
</div>
</div>
<div class="col-lg-3 col-md-6 col-12">
<div class="single-footer f-link">
<h2>Quick Links</h2>
<div class="row">
<div class="col-lg-6 col-md-6 col-12">
<ul>
<li><a href="#"><i class="fa fa-caret-right" aria-hidden="true"></i>Home</a></li>
<li><a href="#"><i class="fa fa-caret-right" aria-hidden="true"></i>About Us</a></li>
<li><a href="#"><i class="fa fa-caret-right" aria-hidden="true"></i>Services</a></li>
<li><a href="#"><i class="fa fa-caret-right" aria-hidden="true"></i>Our Cases</a></li>
<li><a href="#"><i class="fa fa-caret-right" aria-hidden="true"></i>Other Links</a></li>
</ul>
</div>
<div class="col-lg-6 col-md-6 col-12">
<ul>
<li><a href="#"><i class="fa fa-caret-right" aria-hidden="true"></i>Consuling</a></li>
<li><a href="#"><i class="fa fa-caret-right" aria-hidden="true"></i>Finance</a></li>
<li><a href="#"><i class="fa fa-caret-right" aria-hidden="true"></i>Testimonials</a></li>
<li><a href="#"><i class="fa fa-caret-right" aria-hidden="true"></i>FAQ</a></li>
<li><a href="#"><i class="fa fa-caret-right" aria-hidden="true"></i>Contact Us</a></li>
</ul>
</div>
</div>
</div>
</div>
<div class="col-lg-3 col-md-6 col-12">
<div class="single-footer">
<h2>Open Hours</h2>
<p>Lorem ipsum dolor sit ame consectetur adipisicing elit do eiusmod tempor incididunt.</p>
<ul class="time-sidual">
<li class="day">Monday - Fridayp <span>8.00-20.00</span></li>
<li class="day">Saturday <span>9.00-18.30</span></li>
<li class="day">Monday - Thusday <span>9.00-15.00</span></li>
</ul>
</div>
</div>
<div class="col-lg-3 col-md-6 col-12">
<div class="single-footer">
<h2>Newsletter</h2>
<p>subscribe to our newsletter to get allour news in your inbox.. Lorem ipsum dolor sit amet, consectetur adipisicing elit,</p>
<form action="mail/mail.php" method="get" target="_blank" class="newsletter-inner">
<input name="email" placeholder="Email Address" class="common-input" onfocus="this.placeholder = ''"
onblur="this.placeholder = 'Your email address'" required="" type="email">
<button class="button"><i class="icofont icofont-paper-plane"></i></button>
</form>
</div>
</div>
</div>
</div>
</div>
<!--/ End Footer Top -->
<!-- Copyright -->
<div class="copyright">
<div class="container">
<div class="row">
<div class="col-lg-12 col-md-12 col-12">
<div class="copyright-content">
<p>© Copyright 2018 | All Rights Reserved by <a href="https://www.wpthemesgrid.com" target="_blank">wpthemesgrid.com</a> </p>
</div>
</div>
</div>
</div>
</div>
<!--/ End Copyright -->
</footer>
<!--/ End Footer Area -->
<!-- jquery Min JS -->
<script src="js/jquery.min.js"></script>
<!-- jquery Migrate JS -->
<script src="js/jquery-migrate-3.0.0.js"></script>
<!-- jquery Ui JS -->
<script src="js/jquery-ui.min.js"></script>
<!-- Easing JS -->
<script src="js/easing.js"></script>
<!-- Color JS -->
<script src="js/colors.js"></script>
<!-- Popper JS -->
<script src="js/popper.min.js"></script>
<!-- Bootstrap Datepicker JS -->
<script src="js/bootstrap-datepicker.js"></script>
<!-- Jquery Nav JS -->
<script src="js/jquery.nav.js"></script>
<!-- Slicknav JS -->
<script src="js/slicknav.min.js"></script>
<!-- ScrollUp JS -->
<script src="js/jquery.scrollUp.min.js"></script>
<!-- Niceselect JS -->
<script src="js/niceselect.js"></script>
<!-- Tilt Jquery JS -->
<script src="js/tilt.jquery.min.js"></script>
<!-- Owl Carousel JS -->
<script src="js/owl-carousel.js"></script>
<!-- counterup JS -->
<script src="js/jquery.counterup.min.js"></script>
<!-- Steller JS -->
<script src="js/steller.js"></script>
<!-- Wow JS -->
<script src="js/wow.min.js"></script>
<!-- Magnific Popup JS -->
<script src="js/jquery.magnific-popup.min.js"></script>
<!-- Counter Up CDN JS -->
<script src="http://cdnjs.cloudflare.com/ajax/libs/waypoints/2.0.3/waypoints.min.js"></script>
<!-- Google Map API Key JS -->
<script src="https://maps.google.com/maps/api/js?key=AIzaSyDGqTyqoPIvYxhn_Sa7ZrK5bENUWhpCo0w"></script>
<!-- Gmaps JS -->
<script src="js/gmaps.min.js"></script>
<!-- Map Active JS -->
<script src="js/map-active.js"></script>
<!-- Bootstrap JS -->
<script src="js/bootstrap.min.js"></script>
<!-- Main JS -->
<script src="js/main.js"></script>
</body>
</html>