Comments and Feedback
From Faculty of Medicine Online Museum and Archive
(Difference between revisions)
| Line 5: | Line 5: | ||
<div><form name="alumnifeedback" method="post" action="/museum/feedback_dbform.php"> | <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"> | ||
| + | <input type="hidden" name="db_time" value="<?=date("d/m/Y G:i")?>" /> | ||
<table><tr> | <table><tr> | ||
<td valign="top"><div align="right">First name</div></td> | <td valign="top"><div align="right">First name</div></td> | ||
Revision as of 07:16, 29 September 2009
This site is in development and we welcome your feedback and contributions. Enquiries can also be directed to the managing curator Dr Lise Mellor.
<form name="alumnifeedback" method="post" action="/museum/feedback_dbform.php">
</form>
<input type="hidden" name ="db_enqtype" value ="feedback"> <input type="hidden" name="db_time" value="<?=date("d/m/Y G:i")?>" />
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="60" rows="5" tabindex="10"></textarea> |
| <input type="submit" name="Submit" value="Submit" tabindex="100"> |