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From Justii1311, 1 Year ago, written in PHP.
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  1. <?php
  2.         session_start();
  3.  
  4.         include("getCity.php");
  5.         include("getClinicsAll.php");
  6.  
  7. ?>
  8. <html>
  9. <head>
  10.  
  11. <style>
  12. .center {
  13.     margin: auto;
  14.     width: 60%;
  15.     padding: 10px;
  16. }
  17. </style>
  18.  
  19.           <meta http-equiv="content-type" content="text/html; charset=utf-8">            
  20.         <meta http-equiv="X-UA-Compatible" content="IE=edge, chrome=1">        
  21.            <script src="https://code.jquery.com/jquery-1.12.4.js"></script>  
  22.  
  23.         <script type="text/javascript" src="js/javascript2.js"></script>
  24.         <!-- Latest compiled and minified CSS -->
  25. <link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.7/css/bootstrap.min.css" integrity="sha384-BVYiiSIFeK1dGmJRAkycuHAHRg32OmUcww7on3RYdg4Va+PmSTsz/K68vbdEjh4u" crossorigin="anonymous">
  26.  
  27. <!-- Optional theme -->
  28. <link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.7/css/bootstrap-theme.min.css" integrity="sha384-rHyoN1iRsVXV4nD0JutlnGaslCJuC7uwjduW9SVrLvRYooPp2bWYgmgJQIXwl/Sp" crossorigin="anonymous">
  29.  
  30. <!-- Latest compiled and minified JavaScript -->
  31. <script src="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.7/js/bootstrap.min.js" integrity="sha384-Tc5IQib027qvyjSMfHjOMaLkfuWVxZxUPnCJA7l2mCWNIpG9mGCD8wGNIcPD7Txa" crossorigin="anonymous"></script>
  32.    <link href="https://cdnjs.cloudflare.com/ajax/libs/select2/4.0.3/css/select2.min.css" rel="stylesheet" />
  33.         <script src="https://cdnjs.cloudflare.com/ajax/libs/select2/4.0.3/js/select2.min.js"></script>
  34.       <link rel="stylesheet" href="css/style.css">
  35.   <meta charset="utf-8">
  36.     <title>Rejestracja</title>
  37.    
  38.  
  39.     <link rel="stylesheet" href="http://fonts.googleapis.com/css?family=Open+Sans:400,700">
  40.        
  41.         <link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.6/css/bootstrap.min.css" integrity="sha384-1q8mTJOASx8j1Au+a5WDVnPi2lkFfwwEAa8hDDdjZlpLegxhjVME1fgjWPGmkzs7" crossorigin="anonymous">
  42.  
  43.        
  44.        
  45. </head>
  46.  
  47. <body><div class="center">
  48. <div class="row">
  49.  
  50.  <div class="col-md-1 col-md-offset-4">
  51.         <img src="logo_icon.png" width="60" height="60">
  52. </div> 
  53.   <div class="col-md-2 col-md-offset-0">
  54.         <h3>Rejestracja</h3>
  55. </div>
  56. </div>
  57.  
  58.  
  59.   <form id="contact" name="form" method="post" action="">
  60.                                                        
  61. <fieldset>
  62. <span><label>Wybierz miasto, w którym znajduje się klinika w której pracujesz: </label></span>
  63. <p id="categoriesCity">
  64.  
  65.         <select name='city' id="categoriesCity-select" class="city-select">
  66. <?php
  67.         while($sizeCity2>0){
  68.          $sizeCity2--;
  69.         echo '<option value=' . $cities[$sizeCity2]['id'] .'>' . $cities[$sizeCity2]['name'] . '</option>';
  70.         }
  71.                 ?>
  72.  </select>
  73.  </p>
  74.             </fieldset>
  75.                 <p id="subcategoriesCity"> </p>
  76.        
  77.         <script>
  78.                 $('#categoriesCity-select').change(function(){
  79.                         if ($(this).val()=='') {
  80.                                 return false;
  81.                         }
  82.                         $.get('subcategoriesClinic.php', {'id':$(this).val()}, function(data){
  83.                                 $('#subcategoriesCity').html(data);
  84.                         });
  85.                 });
  86.         </script>
  87.          
  88.     <fieldset>
  89.       <input class="form-control" placeholder="Imie" type="text" name='name' id="name" tabindex="1" required >
  90.     </fieldset>
  91.     <fieldset>
  92.       <input class="form-control" placeholder="Nazwisko" type="text" name='surname' tabindex="2" required >
  93.     </fieldset>
  94.  
  95.                        
  96.             <fieldset>
  97.       <input class="form-control" placeholder="NIP" type="text" name='NIP' pattern="[0-9]{10}" tabindex="9" >
  98.     </fieldset>
  99.     <fieldset>
  100.       <input class="form-control"  placeholder="Skype" type="text" id='skype' tabindex="10" >
  101.     </fieldset>
  102.     <fieldset>
  103.       <input class="form-control" placeholder="Telefon" type="tel" pattern="[0-9]{9}" name='phone' tabindex="11" >
  104.     </fieldset>
  105.             <fieldset>
  106.       <input class="form-control" placeholder="Email" type="email" name='email' tabindex="12" required>
  107.     </fieldset>
  108.                  <fieldset>
  109.       <input class="form-control" placeholder="Nazwa uzytkownika" name='username' type="text" tabindex="13" required >
  110.     </fieldset>
  111.         <fieldset>
  112.       <input class="form-control"  placeholder="Hasło" name='password1'  id="password1"   type="password" tabindex="14" required >
  113.     </fieldset>        
  114.         <fieldset>
  115.       <input class="form-control" placeholder="Powtórz hasło" name='password2' id="password2" type="password" tabindex="14" required >
  116.     </fieldset>
  117. <p id="validate-status"></p>
  118.  
  119.              <center><input  class="btn btn-primary" type="button" style="width: 400px"  onclick="create();" value="Zarejestruj się"/></center>
  120.   </form>
  121. </div>
  122.  
  123.  
  124. </div>
  125.     <script>
  126.         $(document).ready(function() {
  127.                 $("#password2").keyup(validate);
  128.         });
  129.         </script>
  130. </body>
  131. </html>
  132.