Comments and Feedback
From Faculty of Medicine Online Museum and Archive
(Difference between revisions)
| Line 1: | Line 1: | ||
| - | <div><form name="alumnifeedback" method="post" action=" | + | <div><form name="alumnifeedback" method="post" action="/museum/feedback_dbform.php"> |
<input type="hidden" name ="db_enqtype" value ="feedback"> | <input type="hidden" name ="db_enqtype" value ="feedback"> | ||
<table><tr> | <table><tr> | ||
Revision as of 03:51, 19 February 2009
<form name="alumnifeedback" method="post" action="/museum/feedback_dbform.php">
</form>
<input type="hidden" name ="db_enqtype" value ="feedback">
First name |
<input type="text" name="db_firstname" value="" tabindex="1" > |
Surname |
<input type="text" name="db_surname" value="" tabindex="2"> |
Email |
<input type="text" name="db_email" tabindex="3"> |
Phone |
<input type="text" name="db_phone" tabindex="6"> |
Comment |
<textarea name="db_comment" cols="40" rows="5" tabindex="10"></textarea> |
| <input type="submit" name="Submit" value="Submit" tabindex="100"> |