Hallo allen, ik hoop dat jullie mij een beetje verder op zeg kunnen helpen.
Ik heb een Form in HTML opgezet; da tstuur ik door via email.
Krijg het form netjes binnen + juiste subject op mijn emailadres.
Echter is het een beetje onoverzichtelijk.
Uitvoer in email is nu blaat = ....
Maar omdat alle velden een andere naam en grootte hebben ziet dit er niet echt netjes uit.
Verder moet het form controleerd worden, zodat daadwerkelijk alle velden ingevuld worden.
Hieronder wat ik tot nu toe heb:
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<form name="Two Incision Candidate detail Form" method="POST" action="mailto:M.alonso@chello.nl?subject=Two Incision Candidate detail Form" enctype="text/plain">
<p align="center">
<b><font size="5">Two Incision Candidate detail</font></b></p>
<p align="left">Name :
<input type="text" name="Name" size="20"></p>
<p align="left">Email :
<input type="text" name="Email" size="41"></p>
<p align="left">Tel No :
<input type="text" name="Tel_No" size="29">
Fax No : <input type="text" name="Fax_No" size="27"></p>
<p align="left">Full Hospital Address :
Home Address : </p>
<p align="left">
<textarea rows="5" name="Full_Hospital_address" cols="29"></textarea>
<textarea rows="5" name="Home_Address" cols="29"></textarea></p>
<p align="left">Practising Sector : Private
<input type="radio" value="Private" checked name="Practising_Sector"> Public
<input type="radio" name="Practising_Sector" value="Public"></p>
<p align="left">Current stem and Usage per year Zimmer :
<input type="text" name="Current_stem_and_Usage_per_year_Zimmer" size="20"></p>
<p align="left">How many Zimmer MIS hip procedures completed
to date ?
<input type="text" name="How_many_Zimmer_MIS_hip_procedures_completed_to_date" size="20"></p>
<p align="left">Current stem and usage per year Competitor :
<input type="text" name="Current_stem_and_usage_per_year_competitor" size="20"></p>
<p align="left">Zimmer consultant surgeon ? Yes
<input type="radio" name="Zimmer_consultant_surgeon" value="YES" checked> No
<input type="radio" name="Zimmer_consultant_surgeon" value="NO"></p>
<p align="left">Zimmer MIS confidential agreement signed ? Yes
<input type="radio" name="Zimmer_MIS_confidential_agreement_signed" value="YES" checked> No
<input type="radio" name="Zimmer_MIS_confidential_agreement_signed" value="NO"></p>
<p align="left">Preferred Date and Venue :</p>
<p align="left">Date:
<input type="text" name="Preferred_Date" size="20"></p>
<p align="left">Venue :</p>
<p align="left">
<textarea rows="5" name="Preferred_Venue" cols="29"></textarea></p>
<p align="left">
<input type="submit" value="Submit" name="Button1"><input type="reset" value="Reset" name="Button2"></p>
<p align="left">
<font size="2">* </font><b><font size="2"><i>Please note:</i>
</font></b><font size="2">The faculty de Medicine require all
participants to be immunised against Hepatitis</font></p>
</form>
Ik heb een Form in HTML opgezet; da tstuur ik door via email.
Krijg het form netjes binnen + juiste subject op mijn emailadres.
Echter is het een beetje onoverzichtelijk.
Uitvoer in email is nu blaat = ....
Maar omdat alle velden een andere naam en grootte hebben ziet dit er niet echt netjes uit.
Verder moet het form controleerd worden, zodat daadwerkelijk alle velden ingevuld worden.
Hieronder wat ik tot nu toe heb:
---------------------------------------------------------------------------------------
<form name="Two Incision Candidate detail Form" method="POST" action="mailto:M.alonso@chello.nl?subject=Two Incision Candidate detail Form" enctype="text/plain">
<p align="center">
<b><font size="5">Two Incision Candidate detail</font></b></p>
<p align="left">Name :
<input type="text" name="Name" size="20"></p>
<p align="left">Email :
<input type="text" name="Email" size="41"></p>
<p align="left">Tel No :
<input type="text" name="Tel_No" size="29">
Fax No : <input type="text" name="Fax_No" size="27"></p>
<p align="left">Full Hospital Address :
Home Address : </p>
<p align="left">
<textarea rows="5" name="Full_Hospital_address" cols="29"></textarea>
<textarea rows="5" name="Home_Address" cols="29"></textarea></p>
<p align="left">Practising Sector : Private
<input type="radio" value="Private" checked name="Practising_Sector"> Public
<input type="radio" name="Practising_Sector" value="Public"></p>
<p align="left">Current stem and Usage per year Zimmer :
<input type="text" name="Current_stem_and_Usage_per_year_Zimmer" size="20"></p>
<p align="left">How many Zimmer MIS hip procedures completed
to date ?
<input type="text" name="How_many_Zimmer_MIS_hip_procedures_completed_to_date" size="20"></p>
<p align="left">Current stem and usage per year Competitor :
<input type="text" name="Current_stem_and_usage_per_year_competitor" size="20"></p>
<p align="left">Zimmer consultant surgeon ? Yes
<input type="radio" name="Zimmer_consultant_surgeon" value="YES" checked> No
<input type="radio" name="Zimmer_consultant_surgeon" value="NO"></p>
<p align="left">Zimmer MIS confidential agreement signed ? Yes
<input type="radio" name="Zimmer_MIS_confidential_agreement_signed" value="YES" checked> No
<input type="radio" name="Zimmer_MIS_confidential_agreement_signed" value="NO"></p>
<p align="left">Preferred Date and Venue :</p>
<p align="left">Date:
<input type="text" name="Preferred_Date" size="20"></p>
<p align="left">Venue :</p>
<p align="left">
<textarea rows="5" name="Preferred_Venue" cols="29"></textarea></p>
<p align="left">
<input type="submit" value="Submit" name="Button1"><input type="reset" value="Reset" name="Button2"></p>
<p align="left">
<font size="2">* </font><b><font size="2"><i>Please note:</i>
</font></b><font size="2">The faculty de Medicine require all
participants to be immunised against Hepatitis</font></p>
</form>