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272 lines
6.9 KiB
272 lines
6.9 KiB
6 months ago
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<?php
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// Initialize variables for form data (if form is submitted)
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$name = $age = $blood_group = $contact = $email = $address = "";
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if ($_SERVER["REQUEST_METHOD"] == "POST") {
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$name = $_POST['name'];
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$age = $_POST['age'];
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$blood_group = $_POST['blood-group'];
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$contact = $_POST['contact'];
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$email = $_POST['email'];
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$address = $_POST['address'];
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}
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?>
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<!DOCTYPE html>
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<html lang="en">
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<head>
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<meta charset="UTF-8" />
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<meta name="viewport" content="width=device-width, initial-scale=1.0" />
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<title>Blood Donation - Save Lives</title>
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<style>
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/* General Styles */
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body {
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margin: 0;
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font-family: Arial, sans-serif;
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background-color: #f9f9f9;
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color: #333;
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}
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header {
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background-color: #d32f2f;
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color: white;
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padding: 10px 20px;
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display: flex;
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justify-content: space-between;
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align-items: center;
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}
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header .logo {
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font-size: 24px;
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font-weight: bold;
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}
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header nav ul {
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list-style: none;
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display: flex;
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margin: 0;
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padding: 0;
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}
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header nav ul li {
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margin: 0 10px;
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}
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header nav ul li a {
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color: white;
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text-decoration: none;
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font-size: 16px;
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}
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header nav ul li a:hover {
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text-decoration: underline;
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}
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/* Hero Section */
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.hero {
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background: url("bloods.jpg") no-repeat center center/cover;
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height: 600px;
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display: flex;
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justify-content: center;
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align-items: center;
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text-align: center;
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color: white;
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position: relative;
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}
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.hero::before {
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content: "";
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position: absolute;
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top: 0;
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left: 0;
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width: 100%;
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height: 100%;
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background-color: rgba(0, 0, 0, 0.5); /* Dark overlay */
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}
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.hero-content {
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z-index: 1;
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}
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.hero-content h1 {
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font-size: 48px;
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margin-bottom: 20px;
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}
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.hero-content button {
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background-color: #c62828;
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color: white;
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padding: 12px 20px;
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font-size: 18px;
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border: none;
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border-radius: 5px;
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cursor: pointer;
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transition: background-color 0.3s ease;
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}
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/* Hidden Form */
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#donation-form {
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display: none;
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}
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/* Container */
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.container {
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max-width: 800px;
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margin: 40px auto;
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padding: 20px;
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background-color: white;
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border-radius: 8px;
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box-shadow: 0 4px 10px rgba(0, 0, 0, 0.1);
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}
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.container h2 {
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text-align: center;
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margin-bottom: 20px;
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}
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.donation-form {
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display: flex;
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flex-direction: column;
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gap: 15px;
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}
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.donation-form label {
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font-weight: bold;
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}
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.donation-form input,
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.donation-form select,
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.donation-form textarea {
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width: 100%;
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padding: 10px;
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border: 1px solid #ccc;
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border-radius: 5px;
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}
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.donation-form button {
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background-color: #2fd371;
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color: white;
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padding: 12px;
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font-size: 18px;
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border: none;
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border-radius: 5px;
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cursor: pointer;
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transition: background-color 0.3s ease;
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}
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.donation-form button:hover {
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}
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/* Footer */
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footer {
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color: white;
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text-align: center;
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padding: 10px;
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margin-top: 20px;
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}
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</style>
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</head>
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<body>
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<section
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class="hero"
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style="background: url('bloodee.png') no-repeat center center/cover"
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>
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<div class="hero-content">
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<h1>Donate Blood, Save Lives</h1>
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<h2>Become a Donor</h2>
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<button onclick="showForm()">Click Here</button>
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</div>
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</section>
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<div class="container" id="donation-form">
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<h2>Blood Donation Registration</h2>
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<form class="donation-form" action="blood.php" method="POST">
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<!-- Full Name -->
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<label for="name">Full Name:</label>
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<input
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type="text"
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id="name"
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name="name"
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placeholder="Enter your full name"
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value="<?php echo htmlspecialchars($name); ?>"
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required
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/>
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<!-- Age -->
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<label for="age">Age:</label>
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<input
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type="number"
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id="age"
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name="age"
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placeholder="Enter your age"
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min="18"
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max="65"
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value="<?php echo htmlspecialchars($age); ?>"
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required
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/>
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<!-- Blood Group -->
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<label for="blood-group">Blood Group:</label>
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<select id="blood-group" name="blood-group" required>
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<option value="">Select your blood group</option>
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<option value="A+" <?php if ($blood_group == 'A+') echo 'selected'; ?>>A+</option>
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<option value="A-" <?php if ($blood_group == 'A-') echo 'selected'; ?>>A-</option>
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<option value="B+" <?php if ($blood_group == 'B+') echo 'selected'; ?>>B+</option>
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<option value="B-" <?php if ($blood_group == 'B-') echo 'selected'; ?>>B-</option>
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<option value="O+" <?php if ($blood_group == 'O+') echo 'selected'; ?>>O+</option>
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<option value="O-" <?php if ($blood_group == 'O-') echo 'selected'; ?>>O-</option>
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<option value="AB+" <?php if ($blood_group == 'AB+') echo 'selected'; ?>>AB+</option>
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<option value="AB-" <?php if ($blood_group == 'AB-') echo 'selected'; ?>>AB-</option>
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</select>
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<!-- Contact Number -->
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<label for="contact">Contact Number:</label>
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<input
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type="tel"
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id="contact"
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name="contact"
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placeholder="Enter your phone number"
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value="<?php echo htmlspecialchars($contact); ?>"
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required
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/>
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<!-- Email -->
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<label for="email">Email:</label>
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<input
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type="email"
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id="email"
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name="email"
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placeholder="Enter your email address"
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value="<?php echo htmlspecialchars($email); ?>"
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required
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/>
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<!-- Address -->
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<label for="address">Address:</label>
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<textarea
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id="address"
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name="address"
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rows="3"
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placeholder="Enter your complete address"
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required
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><?php echo htmlspecialchars($address); ?></textarea>
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<!-- Submit Button -->
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<button type="submit">Register as a Donor</button>
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</form>
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<?php if ($_SERVER["REQUEST_METHOD"] == "POST"): ?>
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<p>Thank you, <?php echo htmlspecialchars($name); ?>! You have successfully registered as a blood donor.</p>
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<?php endif; ?>
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</div>
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<script>
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function showForm() {
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const form = document.getElementById("donation-form");
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form.style.display = "block";
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form.scrollIntoView({ behavior: "smooth" });
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}
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</script>
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</body>
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</html>
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