| Name Of Female Partner : | ".$_POST[name1]." |
";
$strhtml=$strhtml."| Name of Male Partner : | ".$_POST[name2]." |
";
$strhtml=$strhtml."| Email id : | ".$_POST[email]." |
";
$strhtml=$strhtml."| Place Of Residence: | ".$_POST[place]." |
";
//$strhtml=$strhtml."| Address : | ".$_POST[address]." |
";
$strhtml=$strhtml."| Mobile No: | ".$_POST[phone]." |
";
$strhtml=$strhtml."| How long have you been trying to get pregnant? : | ".$_POST[long]." |
";
$strhtml=$strhtml."| Reason given for infertility: | ".$_POST[reason]." |
";
/*$strhtml=$strhtml."| Medical History of Female Partner |
";*/
$strhtml=$strhtml."| Medical History of Female Partner |
";
$strhtml=$strhtml."| Age: | ".$_POST[age]." |
";
$strhtml=$strhtml."| Height: | ".$_POST[height]." |
";
$strhtml=$strhtml."| Weight: | ".$_POST[weight]." |
";
$strhtml=$strhtml."| Details of menstrual cycle: | ".$_POST[menstrual]." |
";
$strhtml=$strhtml."| Details of any fertility tests: | ".$_POST[ftests]." |
";
$strhtml=$strhtml."| No.of Miscariages/Abortions: | ".$_POST[abortions]." |
";
$strhtml=$strhtml."| Number of previous live birth: | ".$_POST[live]." |
";
$strhtml=$strhtml."| Details of any previous Art: | ".$_POST[art]." |
";
$strhtml=$strhtml."| Current medication: | ".$_POST[cmedication]." |
";
$strhtml=$strhtml."| Medical History of Male Partner |
";
$strhtml=$strhtml."| Male Partner Age: | ".$_POST[age1]." |
";
$strhtml=$strhtml."| Male Partner Weight: | ".$_POST[weight1]." |
";
$strhtml=$strhtml."| Male Partner Height: | ".$_POST[height1]." |
";
$strhtml=$strhtml."| Have you had a semen analysis report?: | ".$_POST[semen]." |
";
$strhtml=$strhtml."| If yes, Date of Report?: | ".$_POST[dreport]." |
";
$strhtml=$strhtml."| Semen Count: | ".$_POST[scount]." |
";
$strhtml=$strhtml."| Motility: | ".$_POST[motility]." |
";
$strhtml=$strhtml."| Current Medication: | ".$_POST[currentmedication]." |
";
//echo "strng=".$strhtml;
//$tom="sandy.jlll@gmail.com" ;
$tom="msairam76@gmail.com,umashankarivf@gmail.com" ;
//$tom="sandy.jlll@gmail.com,sarat@visaexporters.com";
$subject="Online Consultation Details from $name1";
$msg = $strhtml;
$headers = "MIME-Version: 1.0\r\n";
$headers .= "Content-type: text/html; charset=iso-8859-1\r\n";
$headers .= "From: $name < $email > \r\n";
mail($tom, $subject, $msg, $headers);
/*if($mailsent)
{
echo "mail sent successfully...";
}
else
{
echo "There is some error...";
}
*///alert
$success=1;
}
?>
