Viewing file:  requestform.php (1.7 KB) -rw-r--r--
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<!DOCTYPE html>
<html>
<head>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0, shrink-to-fit=no">
<title>Compalin Form</title>
<link rel="stylesheet" href="request_form/assets/bootstrap/css/bootstrap.min.css">
<link rel="stylesheet" href="request_form/assets/css/Pretty-Registration-Form.css">
<link rel="stylesheet" href="request_form/assets/css/styles.css">
</head>
<body>
<form id="form1" name="form1" method="post" action="comaplaindata.php" enctype="multipart/form-data">
<div class="row register-form">
<div class="col-md-8 offset-md-2">
<form class="custom-form">
<h1>Online Complain Form</h1>
<div class="form-row form-group">
<div class="col-sm-4 label-column"><label class="col-form-label" for="name-input-field">USER NAME</label></div>
<div class="col-sm-6 input-column"><input class="form-control" readonly type="text" name='userid' value='<?php echo $user ?>'></div>
</div>
<div class="form-row form-group">
<div class="col-sm-4 label-column"><label class="col-form-label" for="email-input-field">YOUR COMPLAIN</label></div>
<div class="col-sm-6 input-column"><textarea rows="4" cols="50" class="form-control" type="email" name='complain' ></textarea></div>
</div>
<input type="submit" name="ADD" id="ADD" value="ADD" tabindex="22" /></form>
</div>
</div>
<script src="request_form/assets/js/jquery.min.js"></script>
<script src="request_form/assets/bootstrap/js/bootstrap.min.js"></script>
</body>
</html>
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