add.php

<?php include('header.php');
include('config.php');

?>
<main class="container">

  <div class="row">
    <div class="col-md-12">
      <form action="add-process.php" method="post">

        <div class="form-group">
          <label for="">Tên bệnh nhân</label>
          <input type="text" name="fname" id="" class="form-control" placeholder="" aria-describedby="helpId">
        </div>
        <div class="form-group">
          <label for="">Họ</label>
          <input type="text" name="lname" id="" class="form-control" placeholder="" aria-describedby="helpId">
        </div>
        <div class="form-group">
          <label for="">Ngày sinh </label>
          <input type="date" name="date" id="" class="form-control">
        </div>
        <div class="form-group">
          <label for="">Giới tính</label><br>
          <input type="radio" id="male" name="gender" value="nam" checked>
          <label for="male">Nam</label><br>
          <input type="radio" id="female" name="gender" value="nữ">
          <label for="female">Nữ</label><br>
        </div>
        <div class="form-group">
          <label for="">Số điện thoại</label><br>
          <input type="text" name="phone" id="" class="form-control" placeholder="" aria-describedby="helpId">
        </div>
        <div class="form-group">
          <label for="">Email</label><br>
          <input type="email" name="email" id="" class="form-control">
        </div>
        <div class="form-group">
          <label for="">Chiều cao</label><br>
          <input type="number" name="height" id="height" class="form-control" placeholder="" aria-describedby="helpId">
        </div>
        <div class="form-group">
          <label for="">Cân nặng</label><br>
          <input type="number" name="weight" id="weight" class="form-control" placeholder="" aria-describedby="helpId">
        </div>
        <!-- Nhom mau -->
        <div class="form-group">
          <label for=""> Nhóm máu</label>
          <select name="blood" class="form-control" id="">
            <option value="A">A</option>
            <option value="B">B</option>
            <option value="O">O</option>
          </select>
        </div>

        <button type="submit" class="btn btn-primary">Lưu</button>
      </form>

    </div>
  </div>
</main>
<?php include('footer.php') ?>