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form-pendaftaran.php
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form-pendaftaran.php
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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="utf-8">
<meta content="width=device-width, initial-scale=1.0" name="viewport">
<!-- Custom Title -->
<title>
<?php
if (!isset($_GET['page'])) echo "E-Klinik - Form Pendaftaran";
else if($_GET['page'] == "dokterUmum") echo "E-Klinik - Form Pendaftaran Dokter Umum";
else if($_GET['page'] == "poliklinik") echo "E-Klinik - Form Pendaftaran Poliklinik";
?>
</title>
<!-- Google Fonts -->
<link href="https://fonts.googleapis.com/css?family=Open+Sans:300,300i,400,400i,600,600i,700,700i|Raleway:300,300i,400,400i,500,500i,600,600i,700,700i|Poppins:300,300i,400,400i,500,500i,600,600i,700,700i" rel="stylesheet">
<!-- Vendor CSS Files -->
<link href="assets/landingPage/vendor/aos/aos.css" rel="stylesheet">
<link rel="stylesheet" href="https://cdn.jsdelivr.net/npm/bootstrap@4.3.1/dist/css/bootstrap.min.css" integrity="sha384-ggOyR0iXCbMQv3Xipma34MD+dH/1fQ784/j6cY/iJTQUOhcWr7x9JvoRxT2MZw1T" crossorigin="anonymous">
<link href="assets/extensions/bootstrap-icons/font/bootstrap-icons.css" rel="stylesheet">
<link href="assets/landingPage/vendor/boxicons/css/boxicons.min.css" rel="stylesheet">
<link href="assets/landingPage/vendor/glightbox/css/glightbox.min.css" rel="stylesheet">
<link href="assets/landingPage/vendor/remixicon/remixicon.css" rel="stylesheet">
<link href="assets/landingPage/vendor/swiper/swiper-bundle.min.css" rel="stylesheet">
<!-- Template Main CSS File -->
<link href="assets/landingPage/css/style.css" rel="stylesheet">
</head>
<body>
<!-- ======= Header ======= -->
<header id="header" class="fixed-top">
<div class="container d-flex align-items-center justify-content-between">
<h1 class="logo"><a href="index.html">E-Klinik</a></h1>
<!-- .navbar -->
<nav id="navbar" class="navbar">
<ul>
<li><a class="nav-link scrollto active" href="index.php">Home</a></li>
<li><a class="nav-link scrollto" href="index.php#service">Layanan</a></li>
<li><a class="nav-link scrollto" href="index.php#about">Tentang Kami</a></li>
<li><a class="nav-link scrollto" href="index.php#contact">Kontak</a></li>
<li><a class="getstarted scrollto" href="form-pendaftaran.php">Isi Formulir</a></li>
<li><a class="getstarted scrollto" href="login.php">Login</a></li>
</ul>
<i class="bi bi-list mobile-nav-toggle"></i>
</nav>
</div>
</header>
<!-- End Header -->
<!-- main section -->
<main id="main">
<?php
// Pesan Success/Error
if (isset($_GET['status']) && $_GET['status'] == 'sukses') {
include ("popup.php");
}
// Custom Tampilan
if (isset($_GET['page'])) {
include "controller/modul-form.php";
}else{
?>
<!-- ======= Breadcrumbs ======= -->
<section class="breadcrumbs">
<div class="container">
<div class="d-flex justify-content-between align-items-center">
<h2>Daftar Pelayanan</h2>
<ol>
<li><a href="index.php">Home</a></li>
<li>Daftar Pelayanan</li>
</ol>
</div>
</div>
</section>
<!-- End Breadcrumbs -->
<!-- ======= Services Section ======= -->
<section id="services" class="services section-bg">
<div class="container" data-aos="fade-up">
<div class="row">
<div class="col-lg-2"></div>
<div class="col-lg-4 col-md-6 d-flex align-items-stretch mt-4 mt-md-0" data-aos="zoom-in" data-aos-delay="200">
<div class="icon-box iconbox-orange ">
<div class="icon">
<svg width="100" height="100" viewBox="0 0 600 600" xmlns="http://www.w3.org/2000/svg">
<path stroke="none" stroke-width="0" fill="#f5f5f5" d="M300,582.0697525312426C382.5290701553225,586.8405444964366,449.9789794690241,525.3245884688669,502.5850820975895,461.55621195738473C556.606425686781,396.0723002908107,615.8543463187945,314.28637112970534,586.6730223649479,234.56875336149918C558.9533121215079,158.8439757836574,454.9685369536778,164.00468322053177,381.49747125262974,130.76875717737553C312.15926192815925,99.40240125094834,248.97055460311594,18.661163978235184,179.8680185752513,50.54337015887873C110.5421016452524,82.52863877960104,119.82277516462835,180.83849132639028,109.12597500060166,256.43424936330496C100.08760227029461,320.3096726198365,92.17705696193138,384.0621239912766,124.79988738764834,439.7174275375508C164.83382741302287,508.01625554203684,220.96474134820875,577.5009287672846,300,582.0697525312426"></path>
</svg>
<i class="bx bx-file"></i>
</div>
<h4><a href="formulir-umum.php">Pendaftaran ke Dokter Umum</a></h4>
<p>Pendaftaran ini ditujukan kepada pasien yang hanya ingin berobat ke dokter umum di klinik saja.</p>
<a class="btn btn-primary mt-2" href="formulir-umum.php">Daftar ke Dokter Umum</a>
</div>
</div>
<div class="col-lg-4 col-md-6 d-flex align-items-stretch mt-4 mt-lg-0" data-aos="zoom-in" data-aos-delay="300">
<div class="icon-box iconbox-pink">
<div class="icon">
<svg width="100" height="100" viewBox="0 0 600 600" xmlns="http://www.w3.org/2000/svg">
<path stroke="none" stroke-width="0" fill="#f5f5f5" d="M300,541.5067337569781C382.14930387511276,545.0595476570109,479.8736841581634,548.3450877840088,526.4010558755058,480.5488172755941C571.5218469581645,414.80211281144784,517.5187510058486,332.0715597781072,496.52539010469104,255.14436215662573C477.37192572678356,184.95920475031193,473.57363656557914,105.61284051026155,413.0603344069578,65.22779650032875C343.27470386102294,18.654635553484475,251.2091493199835,5.337323636656869,175.0934190732945,40.62881213300186C97.87086631185822,76.43348514350839,51.98124368387456,156.15599469081315,36.44837278890362,239.84606092416172C21.716077023791087,319.22268207091537,43.775223500013084,401.1760424656574,96.891909868211,461.97329694683043C147.22146801428983,519.5804099606455,223.5754009179313,538.201503339737,300,541.5067337569781"></path>
</svg>
<i class="bx bx-tachometer"></i>
</div>
<h4><a href="formulir-poliklinik.php">Pendaftaran ke Poliklinik</a></h4>
<p>Pendaftaran ini ditujukan kepada pasien yang ingin berobat ke poliklinik.</p>
<a class="btn btn-primary mt-2" href="formulir-poliklinik.php">Daftar ke Poliklinik</a>
</div>
</div>
<div class="col-lg-2"></div>
</div>
</div>
</section>
<!-- End Sevices Section -->
<?php } ?>
</main>
<!-- End #main -->
<!-- ======= Footer ======= -->
<footer id="footer">
<div class="container d-md-flex py-4">
<div class="me-md-auto text-center text-md-start">
<div class="copyright">
© Copyright <strong><span>E-Klinik</span></strong>. Didesain oleh <a href="#">E-Klinik</a>
</div>
</div>
</div>
</footer>
<!-- End Footer -->
<div id="preloader"></div>
<a href="#" class="back-to-top d-flex align-items-center justify-content-center"><i class="bi bi-arrow-up-short"></i></a>
<!-- Vendor JS Files -->
<script src="assets/landingPage/vendor/purecounter/purecounter_vanilla.js"></script>
<script src="assets/landingPage/vendor/aos/aos.js"></script>
<script src="assets/landingPage/vendor/bootstrap/js/bootstrap.bundle.min.js"></script>
<script src="assets/landingPage/vendor/glightbox/js/glightbox.min.js"></script>
<script src="assets/landingPage/vendor/isotope-layout/isotope.pkgd.min.js"></script>
<script src="assets/landingPage/vendor/swiper/swiper-bundle.min.js"></script>
<script src="assets/landingPage/vendor/php-email-form/validate.js"></script>
<!-- Template Main JS File -->
<script src="assets/landingPage/js/main.js"></script>
</body>
</html>