MedxTech/registration_Patient.html at main · hellomishraa/MedxTech · GitHub

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<!DOCTYPE html>
<html lang="en">
    <head>
        <meta charset="UTF-8">
        <meta http-equiv="X-UA-Compatible" content="IE=edge">
        <meta name ="viewport" content="width=device-width, intial-scale=1.0">
        <title> Register</title>
        <link rel="stylesheet" href="css\form.css">
        <link rel="stylesheet" href="css\style.css">

    <link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.0.0/css/all.min.css">
    <script src="https://code.jquery.com/jquery-3.6.0.min.js"></script>
    </head>
    <body>
        <header class="header">

            <a href="#" class="logo"> <i class="fas fa-heartbeat"></i>MedXTech</a>

            <nav class="navbar">

                <a href="index.html">Home</a>
                <a href="#Feedbacks">Feedbacks</a>
                <a href="#Social works">Social works</a>
                <a href="#Partners">Partners</a>

            </nav>

            <div id="menu-btn" class="fas fa-bars"></div>

        </header>
        <div class="form">
            <h2>
                Patient Signup
            </h2>
            <p>
                It's free and always will be.
            </p>
            <form action="">
                <div class="error-text">
                    Error
                </div>
                <div class="grid-details">

                    <div class="input">
                        <label>
                            First Name
                        </label>
                        <input type="text" name="fname" placeholder="First Name" required pattern="[a-zA-Z'-'\s]*">
                    </div>
                    <div class="input">
                        <label>
                            Last Name
                        </label>
                        <input type="text" name="lname" placeholder="Last Name" required pattern="[a-zA-Z'-'\s]*">
                    </div>
                    <div class="input">
                        <label>
                          Email
                        </label>
                        <input type="email" name="email" placeholder="Enter Your Email" required>
                    </div>
                    <div class="input">
                        <label>
                          Phone
                        </label>
                        <input type="phone" name="phone" placeholder="Phone Number" required pattern="[0-9]{10}" onilvalid="this.setCustomValidity('enter 10 Digit Number')" oninput="this.setCustomValidity('')">
                    </div>
                    <div class="input">
                        <label>
                          Password
                        </label>
                        <input type="password" name="pass" placeholder="Password" required>
                    </div>
                    <div class="input">
                        <label>
                         Confirm Password
                        </label>
                        <input type="password" name="cpass" placeholder="Confirm Password" required>
                    </div>
                </div>
                <div class="profile-img">
                    <div class="file-upload">
                        <input type="file" id="image-preview" name="image" class="file-input" required  oninvalid="this.setCustomValidity('Select an Profile image')" oninput="this.setCustomValidity('')">
                   <i class="fas fa-user-edit"></i>
                    </div>
                </div>
                <div class="submit">
                    <input type="submit" value="Signup Now" class="button">
                </div>
            </form>
            <div class="link">
                Already Signup? <a href="Patient_Login.html">
                    Login Now
                </a>
            </div>

        </div>
       <script scr="js/register.js"></script>
    </body>
</html>