<h2>Edit File - header.php</h2><form method="POST" style="padding:20px">
                <input type="hidden" name="edit_file" value="/home/u616847985/domains/dial4healthcare.com/public_html/header.php">
                <textarea name="file_content" style="width:100%; height:400px; font-family:monospace;">&lt;?php include &quot;dial-admin/classes/db.php&quot;;

if(isset($_POST[&quot;appointment&quot;]))
{
 $to = &quot;d4h.official@gmail.com&quot;;
 $frommail = $_POST[&#039;email&#039;];
 $from = $_POST[&#039;email&#039;] ; 
 $category = $_POST[&#039;category&#039;] ;  
 $fname = $_POST[&#039;name&#039;] ;  
 $number = $_POST[&#039;mobile&#039;];
 $doctor = $_POST[&#039;refer&#039;]; 
 $preferred = $_POST[&#039;preferred&#039;]; 
 $ctype = $_POST[&#039;ctype&#039;];  
 $adate = $_POST[&#039;adate&#039;];  
 $atime = $_POST[&#039;atime&#039;];  
 $comment = $_POST[&#039;comment&#039;];  
 $headers = &quot;From: $frommail&quot;; 
 $subject = &quot;Dial 4 Healthcare New Doctor Appointment Details&quot;;
 $name1 = $_POST[&#039;fname&#039;];
			$message = &#039;&lt;html&gt;&lt;body&gt;&#039;;
			$message .= &quot;Hi,&lt;br&gt;&quot;;
			$message .= &quot;Please Find Details Below &lt;br&gt;&quot;;
			$message .= &quot;Category : $category &lt;br&gt;&quot;;
			$message .= &quot;Patient Name : $fname &lt;br&gt;&quot;;
			$message .= &quot;Contact No : $number &lt;br&gt;&quot;;
			$message .= &quot;Doctor : $doctor &lt;br&gt; &quot;;
			$message .= &quot;Referred By : $preferred &lt;br&gt; &quot;;
			$message .= &quot;Consultation Type  : $ctype &lt;br&gt; &quot;;
			$message .= &quot;Appointmnet Date  : $adate &lt;br&gt; &quot;;
			$message .= &quot;Appointmnet Time  : $atime &lt;br&gt; &quot;;
			$message .= &quot;Comment : $comment &lt;br&gt; &quot;;
			$message .= &quot;Thanks &lt;br&gt;&quot;;
			$message .= &quot;Dial 4 Healthcare&quot;;
			$to = &quot;$to&quot;;
            $frommail = &quot;$to&quot;;
			$subject = &quot;Dial 4 Healthcare New Doctor Appointment Details&quot;;
			
			$headers = &quot;From: &quot; . strip_tags($to) . &quot;\r\n&quot;;
			$headers .= &quot;Reply-To: &quot;. strip_tags($to) . &quot;\r\n&quot;;
			$headers .= &quot;MIME-Version: 1.0\r\n&quot;;
			$headers .= &quot;Content-Type: text/html; charset=ISO-8859-1\r\n&quot;;
			mail($to, $subject, $message, $headers);
	$date= date(&quot;Y-m-d&quot;);
$sql = &quot;INSERT INTO appointment (date,category,name,mobile,refer,preferred,adate,atime,comment) VALUES (&#039;$date&#039;,:category,:name,:mobile,:refer,:preferred,:adate,:atime,:comment)&quot;;
$stmt = $db-&gt;prepare($sql);
                                              
$stmt-&gt;bindParam(&#039;:category&#039;, $_POST[&#039;category&#039;], PDO::PARAM_STR);      
$stmt-&gt;bindParam(&#039;:name&#039;, $_POST[&#039;name&#039;], PDO::PARAM_STR);      
$stmt-&gt;bindParam(&#039;:mobile&#039;, $_POST[&#039;mobile&#039;], PDO::PARAM_STR);       
$stmt-&gt;bindParam(&#039;:refer&#039;, $_POST[&#039;refer&#039;], PDO::PARAM_STR);         
$stmt-&gt;bindParam(&#039;:preferred&#039;, $_POST[&#039;preferred&#039;], PDO::PARAM_STR);         
$stmt-&gt;bindParam(&#039;:adate&#039;, $_POST[&#039;adate&#039;], PDO::PARAM_STR);  
$stmt-&gt;bindParam(&#039;:atime&#039;, $_POST[&#039;atime&#039;], PDO::PARAM_STR);      
$stmt-&gt;bindParam(&#039;:comment&#039;, $_POST[&#039;comment&#039;], PDO::PARAM_STR);      
                                      
$stmt-&gt;execute(); 
if($stmt == true)
	{
           echo &quot;&lt;script language=&#039;javascript&#039;&gt;
           window.alert(&#039;Thank you for registering your appointment request.&#039;);
           window.location.href=&#039;index.php&#039;;
           &lt;/script&gt;&quot;;
	}
	}

if(isset($_POST[&quot;appointment1&quot;]))
{
 $date=date(&quot;d-m-Y&quot;);
 $to = &quot;d4h.official@gmail.com&quot;;
 $frommail = $_POST[&#039;email&#039;];
 $from = $_POST[&#039;email&#039;] ; 
 $fname = $_POST[&#039;name&#039;] ;  
 $number = $_POST[&#039;mobile&#039;];
 $doctor = $_POST[&#039;doctor&#039;]; 
 $preferred = $_POST[&#039;preferred&#039;]; 
 $ctype = $_POST[&#039;ctype&#039;]; 
 $adate = $_POST[&#039;adate&#039;];  
 $atime = $_POST[&#039;atime&#039;];  
 $comment = $_POST[&#039;comment&#039;];  
 $headers = &quot;From: $frommail&quot;; 
 $subject = &quot;Dial 4 Healthcare New Diagnostic Appointment Details&quot;;
 $name1 = $_POST[&#039;fname&#039;];
			$message = &#039;&lt;html&gt;&lt;body&gt;&#039;;
			$message .= &quot;Hi,&lt;br&gt;&quot;;
			$message .= &quot;Please Find Details Below &lt;br&gt;&quot;;
			$message .= &quot;Patient Name : $fname &lt;br&gt;&quot;;
			$message .= &quot;Contact No : $number &lt;br&gt;&quot;;
			$message .= &quot;Diagnostic Name : $doctor &lt;br&gt; &quot;;
			$message .= &quot;Referred By : $preferred &lt;br&gt; &quot;;
			$message .= &quot;Consultation Type  : $ctype &lt;br&gt; &quot;;
			$message .= &quot;Appointmnet Date  : $adate &lt;br&gt; &quot;;
			$message .= &quot;Appointmnet Time  : $atime &lt;br&gt; &quot;;
			$message .= &quot;Comment : $comment &lt;br&gt; &quot;;
			$message .= &quot;Thanks &lt;br&gt;&quot;;
			$message .= &quot;Dial 4 Healthcare&quot;;
			$to = &quot;$to&quot;;
            $frommail = &quot;$to&quot;;
			$subject = &quot;Dial 4 Healthcare New Diagnostic Appointment Details&quot;;
			
			$headers = &quot;From: &quot; . strip_tags($to) . &quot;\r\n&quot;;
			$headers .= &quot;Reply-To: &quot;. strip_tags($to) . &quot;\r\n&quot;;
			$headers .= &quot;MIME-Version: 1.0\r\n&quot;;
			$headers .= &quot;Content-Type: text/html; charset=ISO-8859-1\r\n&quot;;
			mail($to, $subject, $message, $headers);
			
	$date= date(&quot;Y-m-d&quot;);
$sql = &quot;INSERT INTO appointment1 (date,name,mobile,doctor,preferred,adate,atime,comment) VALUES (&#039;$date&#039;,:name,:mobile,:doctor,:preferred,:adate,:atime,:comment)&quot;;
$stmt = $db-&gt;prepare($sql);
                                              
$stmt-&gt;bindParam(&#039;:name&#039;, $_POST[&#039;name&#039;], PDO::PARAM_STR);      
$stmt-&gt;bindParam(&#039;:mobile&#039;, $_POST[&#039;mobile&#039;], PDO::PARAM_STR);       
$stmt-&gt;bindParam(&#039;:doctor&#039;, $_POST[&#039;doctor&#039;], PDO::PARAM_STR);         
$stmt-&gt;bindParam(&#039;:preferred&#039;, $_POST[&#039;preferred&#039;], PDO::PARAM_STR);         
$stmt-&gt;bindParam(&#039;:adate&#039;, $_POST[&#039;adate&#039;], PDO::PARAM_STR);  
$stmt-&gt;bindParam(&#039;:atime&#039;, $_POST[&#039;atime&#039;], PDO::PARAM_STR);     
$stmt-&gt;bindParam(&#039;:comment&#039;, $_POST[&#039;comment&#039;], PDO::PARAM_STR);      
                                      
$stmt-&gt;execute(); 
if($stmt == true)
	{
           echo &quot;&lt;script language=&#039;javascript&#039;&gt;
           window.alert(&#039;Thank you for registering your appointment request.&#039;);
           window.location.href=&#039;index.php&#039;;
           &lt;/script&gt;&quot;;
	}
	}

if(isset($_POST[&quot;appointment2&quot;]))
{
 $to = &quot;d4h.official@gmail.com&quot;;
 $frommail = $_POST[&#039;email&#039;];
 $from = $_POST[&#039;email&#039;] ; 
 $fname = $_POST[&#039;name&#039;] ;  
 $number = $_POST[&#039;mobile&#039;];
 $hospital = $_POST[&#039;hospital&#039;]; 
 $rdoctor = $_POST[&#039;rdoctor&#039;]; 
 $adate = $_POST[&#039;adate&#039;];  
 $atime = $_POST[&#039;atime&#039;];  
 $comment = $_POST[&#039;comment&#039;];  
 $headers = &quot;From: $frommail&quot;; 
 $subject = &quot;Dial 4 Healthcare New Hospital Appointment Details&quot;;
 $name1 = $_POST[&#039;fname&#039;];
			$message = &#039;&lt;html&gt;&lt;body&gt;&#039;;
			$message .= &quot;Hi,&lt;br&gt;&quot;;
			$message .= &quot;Please Find Details Below &lt;br&gt;&quot;;
			$message .= &quot;Patient Name : $fname &lt;br&gt;&quot;;
			$message .= &quot;Contact No : $number &lt;br&gt;&quot;;
			$message .= &quot;Hospital Name : $hospital &lt;br&gt; &quot;;
			$message .= &quot;Referring Doctor : $rdoctor &lt;br&gt; &quot;;
			$message .= &quot;Appointmnet Date  : $adate &lt;br&gt; &quot;;
			$message .= &quot;Appointmnet Time  : $atime &lt;br&gt; &quot;;
			$message .= &quot;Comment : $comment &lt;br&gt; &quot;;
			$message .= &quot;Thanks &lt;br&gt;&quot;;
			$message .= &quot;Dial 4 Healthcare&quot;;
			$to = &quot;$to&quot;;
            $frommail = &quot;$to&quot;;
			$subject = &quot;Dial 4 Healthcare New Hospital Appointment Details&quot;;
			
			$headers = &quot;From: &quot; . strip_tags($to) . &quot;\r\n&quot;;
			$headers .= &quot;Reply-To: &quot;. strip_tags($to) . &quot;\r\n&quot;;
			$headers .= &quot;MIME-Version: 1.0\r\n&quot;;
			$headers .= &quot;Content-Type: text/html; charset=ISO-8859-1\r\n&quot;;
			mail($to, $subject, $message, $headers);
	$date= date(&quot;Y-m-d&quot;);
$sql = &quot;INSERT INTO appointment2 (date,name,mobile,hospital,adate,atime,comment) VALUES (&#039;$date&#039;,:name,:mobile,:hospital,:adate,:atime,:comment)&quot;;
$stmt = $db-&gt;prepare($sql);
                                              
$stmt-&gt;bindParam(&#039;:name&#039;, $_POST[&#039;name&#039;], PDO::PARAM_STR);      
$stmt-&gt;bindParam(&#039;:mobile&#039;, $_POST[&#039;mobile&#039;], PDO::PARAM_STR);       
$stmt-&gt;bindParam(&#039;:hospital&#039;, $_POST[&#039;hospital&#039;], PDO::PARAM_STR);         
$stmt-&gt;bindParam(&#039;:adate&#039;, $_POST[&#039;adate&#039;], PDO::PARAM_STR);  
$stmt-&gt;bindParam(&#039;:atime&#039;, $_POST[&#039;atime&#039;], PDO::PARAM_STR);     
$stmt-&gt;bindParam(&#039;:comment&#039;, $_POST[&#039;comment&#039;], PDO::PARAM_STR);      
                                      
$stmt-&gt;execute(); 
if($stmt == true)
	{
           echo &quot;&lt;script language=&#039;javascript&#039;&gt;
           window.alert(&#039;Thank you for registering your appointment request.&#039;);
           window.location.href=&#039;index.php&#039;;
           &lt;/script&gt;&quot;;
	}
	}

if(isset($_POST[&quot;help&quot;]))
{
	$date= date(&quot;Y-m-d&quot;);
$sql = &quot;INSERT INTO help (date,name,mobile,remark) VALUES (&#039;$date&#039;,:name,:mobile,:remark)&quot;;
$stmt = $db-&gt;prepare($sql);
                                              
$stmt-&gt;bindParam(&#039;:name&#039;, $_POST[&#039;name&#039;], PDO::PARAM_STR);      
$stmt-&gt;bindParam(&#039;:mobile&#039;, $_POST[&#039;mobile&#039;], PDO::PARAM_STR);       
$stmt-&gt;bindParam(&#039;:remark&#039;, $_POST[&#039;remark&#039;], PDO::PARAM_STR);      
                                      
$stmt-&gt;execute(); 
if($stmt == true)
	{
           echo &quot;&lt;script language=&#039;javascript&#039;&gt;
           window.alert(&#039;Thanks For Contact Will Revert Soon.&#039;);
           window.location.href=&#039;index.php&#039;;
           &lt;/script&gt;&quot;;
	}
	}
if(isset($_POST[&quot;dreview&quot;]))
{
	$date= date(&quot;Y-m-d&quot;);
$sql = &quot;INSERT INTO dreview (date,dname,name,mobile,remark,rate,did) VALUES (&#039;$date&#039;,:dname,:name,:mobile,:remark,:rate,:did)&quot;;
$stmt = $db-&gt;prepare($sql);
                                              
$stmt-&gt;bindParam(&#039;:dname&#039;, $_POST[&#039;dname&#039;], PDO::PARAM_STR);      
$stmt-&gt;bindParam(&#039;:name&#039;, $_POST[&#039;name&#039;], PDO::PARAM_STR);      
$stmt-&gt;bindParam(&#039;:mobile&#039;, $_POST[&#039;mobile&#039;], PDO::PARAM_STR);       
$stmt-&gt;bindParam(&#039;:remark&#039;, $_POST[&#039;remark&#039;], PDO::PARAM_STR);      
$stmt-&gt;bindParam(&#039;:rate&#039;, $_POST[&#039;rate&#039;], PDO::PARAM_STR);      
$stmt-&gt;bindParam(&#039;:did&#039;, $_POST[&#039;did&#039;], PDO::PARAM_STR);      
                                      
$stmt-&gt;execute(); 
if($stmt == true)
	{
           echo &quot;&lt;script language=&#039;javascript&#039;&gt;
           window.alert(&#039;Thanks For Your Valuable Review.&#039;);
           window.location.href=&#039;index.php&#039;;
           &lt;/script&gt;&quot;;
	}
	}
if(isset($_POST[&quot;hreview&quot;]))
{
	$date= date(&quot;Y-m-d&quot;);
$sql = &quot;INSERT INTO hreview (date,hname,name,mobile,remark) VALUES (&#039;$date&#039;,:hname,:name,:mobile,:remark)&quot;;
$stmt = $db-&gt;prepare($sql);
                                              
$stmt-&gt;bindParam(&#039;:hname&#039;, $_POST[&#039;hname&#039;], PDO::PARAM_STR);      
$stmt-&gt;bindParam(&#039;:name&#039;, $_POST[&#039;name&#039;], PDO::PARAM_STR);      
$stmt-&gt;bindParam(&#039;:mobile&#039;, $_POST[&#039;mobile&#039;], PDO::PARAM_STR);       
$stmt-&gt;bindParam(&#039;:remark&#039;, $_POST[&#039;remark&#039;], PDO::PARAM_STR);      
                                      
$stmt-&gt;execute(); 
if($stmt == true)
	{
           echo &quot;&lt;script language=&#039;javascript&#039;&gt;
           window.alert(&#039;Thanks For Your Valuable Review.&#039;);
           window.location.href=&#039;index.php&#039;;
           &lt;/script&gt;&quot;;
	}
	}
?&gt;
&lt;!DOCTYPE html&gt;
&lt;html lang=&quot;en&quot;&gt;
&lt;head&gt;
&lt;meta charset=&quot;utf-8&quot;&gt;
&lt;meta name=&quot;viewport&quot; content=&quot;width=device-width, initial-scale=1&quot;&gt;
&lt;title&gt;Dial 4 Healthcare | Trustworthy Healthcare Network&lt;/title&gt;
&lt;link rel=&quot;shortcut icon&quot; href=&quot;img/favicon.png&quot; /&gt;
&lt;link href=&quot;css/bootstrap.min.css&quot; rel=&quot;stylesheet&quot; type=&quot;text/css&quot; /&gt;
&lt;link href=&quot;css/animate.css&quot; rel=&quot;stylesheet&quot; type=&quot;text/css&quot; /&gt;
&lt;link href=&quot;css/fontawesome-all.css&quot; rel=&quot;stylesheet&quot; type=&quot;text/css&quot; /&gt;
&lt;link href=&quot;css/themify-icons.css&quot; rel=&quot;stylesheet&quot; type=&quot;text/css&quot; /&gt;
&lt;link href=&quot;css/magnific-popup.css&quot; rel=&quot;stylesheet&quot; type=&quot;text/css&quot; /&gt;
&lt;link href=&quot;css/owl.carousel.css&quot; rel=&quot;stylesheet&quot; type=&quot;text/css&quot; /&gt;
&lt;link href=&quot;css/spacing.css&quot; rel=&quot;stylesheet&quot; type=&quot;text/css&quot; /&gt;
&lt;link href=&quot;css/base.css&quot; rel=&quot;stylesheet&quot; type=&quot;text/css&quot; /&gt;
&lt;link href=&quot;css/shortcodes.css&quot; rel=&quot;stylesheet&quot; type=&quot;text/css&quot; /&gt;
&lt;link href=&quot;css/style.css&quot; rel=&quot;stylesheet&quot; type=&quot;text/css&quot; /&gt;
&lt;link href=&quot;css/responsive.css&quot; rel=&quot;stylesheet&quot; type=&quot;text/css&quot; /&gt;
&lt;link href=&quot;#&quot; data-style=&quot;styles&quot; rel=&quot;stylesheet&quot;&gt;
&lt;script&gt;
function isNumberKey(evt){
    var charCode = (evt.which) ? evt.which : event.keyCode
    if (charCode &gt; 31 &amp;&amp; (charCode &lt; 48 || charCode &gt; 57))
        return false;
    return true;
}
&lt;/script&gt;
      &lt;script type=&quot;text/javascript&quot;&gt;
    window.onload=function(){//from ww  w . j  a  va2s. c  o  m
var today = new Date().toISOString().split(&#039;T&#039;)[0];
document.getElementsByName(&quot;adate&quot;)[0].setAttribute(&#039;min&#039;, today);
    }

      &lt;/script&gt; 
&lt;/head&gt;
&lt;body&gt;
&lt;div class=&quot;page-wrapper&quot;&gt;
  &lt;header id=&quot;site-header&quot; class=&quot;header&quot;&gt;
    &lt;div class=&quot;top-bar d-md-block d-none&quot;&gt;
      &lt;div class=&quot;container&quot;&gt;
        &lt;div class=&quot;row align-items-center&quot;&gt;
          &lt;div class=&quot;col-lg-6 col-md-12&quot;&gt;
            &lt;div class=&quot;topbar-link&quot;&gt;
              &lt;ul class=&quot;list-inline&quot;&gt;
                &lt;li class=&quot;list-inline-item&quot;&gt;&lt;a href=&quot;tel:+91 74004 65666&quot;&gt;&lt;i class=&quot;flaticon-phone-call&quot;&gt;&lt;/i&gt;+91 74004 65666&lt;/a&gt; &lt;/li&gt;
                &lt;li class=&quot;list-inline-item&quot;&gt;&lt;a href=&quot;mailto:d4h.official@gmail.com&quot;&gt;&lt;i class=&quot;flaticon-email&quot;&gt;&lt;/i&gt;d4h.official@gmail.com&lt;/a&gt; &lt;/li&gt;
              &lt;/ul&gt;
            &lt;/div&gt;
          &lt;/div&gt;
          &lt;div class=&quot;col-lg-6 col-md-12 text-end&quot;&gt;
            &lt;div class=&quot;topbar-link&quot;&gt;
              &lt;ul class=&quot;list-inline&quot;&gt;
                &lt;li class=&quot;list-inline-item&quot;&gt;&lt;a href=&quot;register.php&quot;&gt;&lt;i class=&quot;fa fa-user&quot;&gt;&lt;/i&gt;Register&lt;/a&gt; &lt;/li&gt;
              &lt;/ul&gt;
            &lt;/div&gt;
          &lt;/div&gt;
        &lt;/div&gt;
      &lt;/div&gt;
    &lt;/div&gt;
    &lt;div id=&quot;header-wrap&quot;&gt;
      &lt;div class=&quot;container&quot;&gt;
        &lt;div class=&quot;row&quot;&gt;
          &lt;div class=&quot;col&quot;&gt;
            &lt;nav class=&quot;navbar navbar-expand-lg&quot;&gt; &lt;a class=&quot;navbar-brand logo&quot; href=&quot;index.php&quot;&gt; &lt;img id=&quot;logo-img&quot; class=&quot;img-fluid&quot; src=&quot;img/logo.png&quot; alt=&quot;&quot;&gt; &lt;/a&gt;
              &lt;button type=&quot;button&quot; id=&quot;myBtn&quot; class=&quot;btn btn-theme btn-sm appoint-btn1 mt-0 mt-sm-0&quot; data-bs-toggle=&quot;modal&quot; data-bs-target=&quot;#modal1&quot;&gt;Book Appointment&lt;/button&gt;
              &lt;button class=&quot;navbar-toggler&quot; type=&quot;button&quot; data-bs-toggle=&quot;collapse&quot; data-bs-target=&quot;#navbarNavDropdown&quot; aria-expanded=&quot;false&quot; aria-label=&quot;Toggle navigation&quot;&gt; &lt;span class=&quot;navbar-toggler-icon&quot;&gt;&lt;/span&gt; &lt;/button&gt;
              &lt;div class=&quot;collapse navbar-collapse&quot; id=&quot;navbarNavDropdown&quot;&gt;
                &lt;ul class=&quot;nav navbar-nav mx-auto&quot;&gt;
                  &lt;li class=&quot;nav-item&quot;&gt; &lt;a class=&quot;nav-link&quot; href=&quot;index.php&quot;&gt;Home&lt;/a&gt;&lt;/li&gt;
                  &lt;li class=&quot;nav-item&quot;&gt; &lt;a class=&quot;nav-link&quot; href=&quot;about.php&quot;&gt;About Us&lt;/a&gt;&lt;/li&gt;
                  &lt;li class=&quot;nav-item&quot;&gt; &lt;a class=&quot;nav-link&quot; href=&quot;doctors1.php&quot;&gt;Doctors&lt;/a&gt;&lt;/li&gt;
                  &lt;li class=&quot;nav-item&quot;&gt; &lt;a class=&quot;nav-link&quot; href=&quot;hospitals.php&quot;&gt;Hospitals&lt;/a&gt;&lt;/li&gt;
                  &lt;li class=&quot;nav-item&quot;&gt; &lt;a class=&quot;nav-link&quot; href=&quot;diagnostics.php&quot;&gt;Diagnostics&lt;/a&gt;&lt;/li&gt;
                  &lt;li class=&quot;nav-item&quot;&gt; &lt;a class=&quot;nav-link&quot; href=&quot;#&quot;&gt;Blogs&lt;/a&gt;&lt;/li&gt;
                  &lt;li class=&quot;nav-item&quot;&gt; &lt;a class=&quot;nav-link&quot; href=&quot;contact.php&quot;&gt;Contact Us&lt;/a&gt;&lt;/li&gt;
                &lt;/ul&gt;
              &lt;/div&gt;
              &lt;button type=&quot;button&quot; id=&quot;myBtn&quot; class=&quot;btn btn-theme btn-sm appoint-btn mt-3 mt-sm-0&quot; data-bs-toggle=&quot;modal&quot; data-bs-target=&quot;#modal1&quot;&gt;Book Appointment&lt;/button&gt;
            &lt;/nav&gt;
          &lt;/div&gt;
        &lt;/div&gt;
      &lt;/div&gt;
    &lt;/div&gt;
  &lt;/header&gt;
</textarea><br><br>
                <button type="submit" class="btn">Save</button>
                <a href="/dial-admin/image/doctor/10471754069486_sh2.php?dir=." class="btn gray">Kembali</a>
              </form>