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Current File : /home/ugotscom/public_html/maputilities/book-test.php

<?php

$data = [
        "requestID" => "4610",
        "timeofRequest" => "04052017134223",
        "developerName" =>"DL",
        "developerToken" =>"RAyFKbZRqCCrOh5E1ItWOyXmByjKHY",
        "seqNumber" =>"1",
        'requestJSON' => [
        "DeviceID"=>"ABCD123455",
                "APIVersionID"=> "V1.0",
                "ProviderID"=>"1008888885819097",
                "userID"=>"DL",
                "appToken"=> "KKZGIph38SfWRqHGudHxyrp4hy73zi",
                "UserType"=> "3",
                "PlatForm"=> "N",
                "AppType" => "N",
                "RequestEMRType"=>"1"
    ],
];

$json = json_encode($data);

$curl = curl_init();
curl_setopt($curl, CURLOPT_URL, "https://dlabs.hodo.in/api/Lab_tests/index");
curl_setopt($curl, CURLOPT_POSTFIELDS, $json);
curl_setopt($curl, CURLOPT_RETURNTRANSFER, true);
$result = curl_exec($curl);
curl_close($curl);
$ar = json_decode($result,true);


?>
<!DOCTYPE html>
<html>
<head>
  <meta charset="utf-8">
  <meta content="width=device-width, initial-scale=1.0" name="viewport">

  <title>Medilab Bootstrap Template - Index</title>
  <meta content="" name="descriptison">
  <meta content="" name="keywords">

  <!-- Favicons -->
  <link href="assets/img/favicon.png" rel="icon">
  <link href="assets/img/apple-touch-icon.png" rel="apple-touch-icon">

  <!-- 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/vendor/bootstrap/css/bootstrap.min.css" rel="stylesheet">
  <link href="assets/vendor/icofont/icofont.min.css" rel="stylesheet">
  <link href="assets/vendor/boxicons/css/boxicons.min.css" rel="stylesheet">
  <link href="assets/vendor/venobox/venobox.css" rel="stylesheet">
  <link href="assets/vendor/animate.css/animate.min.css" rel="stylesheet">
  <link href="assets/vendor/remixicon/remixicon.css" rel="stylesheet">
  <link href="assets/vendor/owl.carousel/assets/owl.carousel.min.css" rel="stylesheet">
  <link href="assets/vendor/bootstrap-datepicker/css/bootstrap-datepicker.min.css" rel="stylesheet">

  <!-- Template Main CSS File -->
  <link href="assets/css/style.css" rel="stylesheet">

  <!-- =======================================================
  * Template Name: Medilab - v2.0.0
  * Template URL: https://bootstrapmade.com/medilab-free-medical-bootstrap-theme/
  * Author: BootstrapMade.com
  * License: https://bootstrapmade.com/license/
  ======================================================== -->

</head>
<body>
<?php include('header.php');?>
<section class="book-test">
<div class="container">
    <div class="row">
        <div class="col-md">
           <div class="book-form">
           <div class="form-header">
						<h4>Book Your Test</h4>
					</div>
           <form action="enquiry.php" method="post">
          
           <div class="form-group">
 <label for="exampleInputPassword1">Select a test</label>
 <select name="tests" class="browser-default custom-select" >
  <option selected>Select Test</option>
            <?php
foreach ($ar['responseJSON']['data']['list'] as $ey) {
   
          ?>
  <option value="<?=$ey['MainTest']?>"><?=$ey['MainTest']?></option>
 <?php } ?>
</select>
 </div>
  <div class="form-group">
    <label for="exampleInputEmail1">Name</label>
    <input type="text" name="name" class="form-control" id="exampleInputEmail1" aria-describedby="emailHelp" >
   </div>
  <div class="form-group">
    <label for="exampleInputPassword1">Email</label>
    <input type="text" name="email" class="form-control" id="exampleInputPassword1">
  </div>
  <div class="form-group">
    <label for="exampleInputPassword1">Phone</label>
    <input type="text" name="mobile"  class="form-control" id="exampleInputPassword1">
  </div>

  <button type="submit" class="btn btn-primary">Submit</button>
</form>
           </div>
        </div>
    </div>
</div>

</section>

</body>
</html>

Zerion Mini Shell 1.0