Risk/contact.html at master · devinvogue/Risk · GitHub

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<!DOCTYPE html>
<html>
<head>
	<meta charset="UTF-8">
    <title> Genesis </title>
    <link rel="stylesheet" href="assets/css/index.css" type="text/css">
</head>

<body>

	<div class="container">

		<div class="header">
		  <a href="index.html#"><img src="assets/images/blood.png" width="100vh" alt="blood logo" /> </a>
		 <h1> GENESIS </h1>
		  <!-- 	Best Blood App </pre> -->
		</div>

		<div class="contactmain">


			<div class="contactInfo">

				<h4> Contact Us on </h4>
				<p> 0202939105 or 0548183328 </p>
				<a href="#"> Facebook </a>
				<a href="#"> Twitter </a>
				<a href="#"> Linkedin </a>
				<a href="#"> Instagram </a>


	 		</div>

	 		<div class="mapstyle">
	 		<h4> Find us Here : Accra Digital Center </h4>

	 		<div id="map" class="mapInfo">

			</div>
	 		</div>

			 <div class="navbar">
				<ul>
					<li><a href="index.html#"> Home </a>  </li>
					<li><a href="about.html#"> About </a> </li>
					<li><a href="contact.html#"> Contact </a> </li>
					<li><button onclick="document.getElementById('form').style.display='block'" style="width:auto;"> Make Appointment </button></li>
				</ul>
			</div>
		</div>

		<!-- Form -->

			<div id="form" class="form">

			  <form class="form-content animate" >
			    <div class="formhead">
			      <span onclick="document.getElementById('form').style.display='none'" class="close" title="Close Modal">&times;</span>
			      <h5> MAKE AN APPOINTMENT </h5>
			    </div>

			    <div class="contain">
			      <label><b>NAME</b></label>
			      <input type="text" placeholder=" eg. Naj Ubarb " name="name" required>

			      <label><b> AGE</b></label>
			      <input type="number" placeholder=" eg. 25 " name="age" required>

			      <label><b> GENDER </b></label>
			      <input type="radio" name="gender" value=" male" checked> Male
			      <input type="radio" name="gender" value=" female"> Female
			      <input type="radio" name="gender" value=" special"> Special
			      <input type="text" placeholder=" eg. If special, Please specify " name="other">

			      <label><b> ADDRESS </b></label>
			      <input type="text" placeholder=" eg. no 4. Kakramundu street, cantonment, Accra. " name="adress" required>

			      <label><b> DATE OF APPOINTMENT</b></label>
			      <input type="number" placeholder=" eg. 28 / 02 / 2018 " name="age" required>

			      <label><b> TIME OF APPOINTMENT</b></label>
			      <input type="number" placeholder=" eg. 13:30 " name="age" required>

			      <label><b> EMAIL</b></label>
			      <input type="email" placeholder=" eg. @brigakyaa@gmail.com " name="email" required>

			      <button type="submit"> Submit </button>

			    </div>
			   </form>
		<div class="footer">
			<p> &copy;2018 by Bridget and Najilau </p>
		</div>

	</div>


	<script>
      function myMap() {
  var mapCanvas = document.getElementById("map");
  var mapOptions = {
    center: new google.maps.LatLng(5.5654507790892565, -0.2227735494409444 ),
    zoom:18,
    mapTypeId:google.maps.MapTypeId.HYBRID
  };
  var map = new google.maps.Map(mapCanvas,mapOptions);
}
</script>

<script src="https://maps.googleapis.com/maps/api/js?key=AIzaSyD20-43m2bJSiB9a9wsImGqfv6z-26CkSs&callback=myMap"></script>

</body>
</html>