| Server IP : 172.67.189.169 / Your IP : 216.73.216.59 Web Server : Apache/2 System : Linux cat167-197.static.lnwhostname.com 5.10.0-20-amd64 #1 SMP Debian 5.10.158-2 (2022-12-13) x86_64 User : paphayomho ( 1042) PHP Version : 5.6.40 Disable Function : exec,system,passthru,shell_exec,proc_close,proc_open,dl,popen,show_source,posix_kill,posix_mkfifo,posix_getpwuid,posix_setpgid,posix_setsid,posix_setuid,posix_setgid,posix_seteuid,posix_setegid,posix_uname MySQL : ON | cURL : ON | WGET : OFF | Perl : OFF | Python : OFF | Sudo : OFF | Pkexec : OFF Directory : /home/paphayomho/domains/paphayomhospital.go.th/private_html/PCU2566/admin/Login/ |
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<?php
include("session.php");
?>
<!DOCTYPE html>
<html>
<head>
<meta name="viewport" content="width=device-width, initial-scale=1">
<link rel="stylesheet" type="text/css" href="css/mystyle1.css" />
</head>
<body>
<div class="icon-bar">
<a href="home.php"><i class="fa fa-home"></i></a>
<a href="users.php"><i class="fa fa-user"></i></a>
<a class="active" href="registration.php"><i class="fa fa-registered"></i></a>
<a href="print_all.php" target="_blank"><i class="fa fa-print"></i></a>
<a href="logout.php"><i class="fa fa-power-off"></i></a>
</div>
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/4.7.0/css/font-awesome.min.css">
<h2>Sign Up</h2>
<hr/>
<form action="register.php" method="POST">
<div class="container">
<input type="text" placeholder="First name" name="firstname" required>
<input type="text" placeholder="Middle name" name="middlename" required>
<input type="text" placeholder="Last name" name="lastname" required>
<label>Birthday</label>
<input type="date" name="birthdate" required>
<input type="text" placeholder="Username" name="username" required>
<input type="password" placeholder="New Password" name="password" required>
<input type="password" placeholder="Repeat Password" name="psw-repeat" required>
<div class="clearfix">
<button type="submit" class="signupbtn">Sign Up</button>
<button type="reset" class="cancelbtn">Cancel</button>
</div>
</div>
</form>