hackathon-2019/index.html at master · exphp-share/hackathon-2019 · GitHub

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<!DOCTYPE HTML>
<!--
	EMRteks
-->
<html>
	<head>
		<title>EMRteks</title>
		<meta charset="utf-8" />
		<meta name="viewport"  content="width=device-width, initial-scale=1, user-scalable=no" />
		<link rel="stylesheet" href="assets/css/main.css" />
		<noscript><link rel="stylesheet" href="assets/css/noscript.css" /></noscript>
	</head>
	<body class="is-preload">
		<!-- Wrapper -->
			<div id="wrapper">


				<!-- Header -->
					<header id="header">

						<div class="inner">

							<!-- Logo -->
								<a href="index.html" class="logo">
									<span class="symbol"><img src="images/logo.svg" alt="" /></span><span class="title">EMRteks.io</span>
								</a>


						</div>
					</header>


				<!-- Main -->
					<div id="main">
						<div class="inner">
							<header>
								<h1>Welcome to EMRteks.io!<br /></h1>
								<p>A lite sms based EMR(Electronic Medical Record) to improve pateint care after in the aftermath of Natural Disasters</p>
							</header>
						</div>
					</div>

				<!-- Footer -->
					<footer id="footer">
						<div class="inner">
							<section>
								<h2>Fill out form for assistance</h2>
								<form name="patient" method="post" action="" />
									<div class="fields">
										<div class="field half">
											<input type="text" name="name" id="name" placeholder="Name" />
										</div>
										<div class="field half">
												<input type="text" name="dob" id="dob" placeholder="Date of Birth" />
											</div>
										<div class="field half">
											<input type="email" name="email" id="email" placeholder="Email" />
										</div>
										<div class="field half">
											<input type="text" name="phone" id="phone" placeholder="Phone" />
										</div>
										<div class="field half">
											<input type="text" name="pin" id="pin" placeholder="Pin" />
										</div>
										<div class="field half">
											<input type="text" name="allergy" id="allergy" placeholder="Allergy" />
										</div>
										<div class="field half">
											<input type="text" name="currentmed" id="currentmed" placeholder="Current Medications" />
										</div>
										<div class="field half">
											<input type="text" name="currentdev" id="currentdev" placeholder="Current Devices" />
										</div>
										<div class="field half">
											<input type="text" name="pastprod" id="pastprod" placeholder="Procedure History" />
										</div>
										<!--
										<div class="field">
											<textarea name="message" id="message" placeholder="Message"></textarea>
										</div>
										-->
									</div>
									<!--
									<input type="file" name="pic" accept="image/*">
									-->

									<ul class="actions">
										<li><input type="submit" value="Send" class="primary" /></li>
									</ul>
								</form>
							</section>


							<ul class="copyright">
								<li>&copy; Drew Bhavsar</li>
							</ul>
						</div>
					</footer>

			</div>

		<!-- Scripts -->
			<script src="assets/js/jquery.min.js"></script>
			<script src="assets/js/browser.min.js"></script>
			<script src="assets/js/breakpoints.min.js"></script>
			<script src="assets/js/util.js"></script>
			<script src="assets/js/main.js"></script>
			<script src="assets/js/hackrpi.js"></script>

	</body>
</html>