File: /var/www/html/hearing-test/mail.php
<?php
$radios_whoom=$_POST['radios_whoom'];
$radios_person=$_POST['radios_person'];
$radios_doctor=$_POST['radios_doctor'];
$radios_hearing=$_POST['radios_hearing'];
$radios_important=$_POST['radios_important'];
$radios_situations=$_POST['radios_situations'];
$radios_restrictd=$_POST['radios_restrictd'];
$radios_tinnitus=$_POST['radios_tinnitus'];
$radios_prevented=$_POST['radios_prevented'];
$radios_affordability=$_POST['radios_affordability'];
$Yes=$_POST['Yes'];
$PIN_CODE=$_POST['PIN_CODE'];
$email=$_POST['email'];
$Mr_ms=$_POST['Mr-ms'];
$fname=$_POST['fname'];
$mno=$_POST['mno'];
$Comment=$_POST['Comment'];
$radios_improved=$_POST['radios_improved'];
/*
echo $radios_whoom."<br>";
echo $radios_person."<br>";
echo $radios_doctor."<br>";
echo $radios_hearing."<br>";
echo $radios_important."<br>";
echo $radios_situations."<br>";
echo $radios_restrictd."<br>";
echo $radios_tinnitus."<br>";
echo $radios_prevented."<br>";
echo $radios_affordability."<br>";
echo $Yes."<br>";
echo $PIN_CODE."<br>";
echo $email."<br>";
echo $Mr_ms."<br>";
echo $fname."<br>";
echo $mno."<br>";
echo $Comment."<br>";*/
$subject = "Enquiry Form | Ashclinic";
//$subject_to_user = "Thank You for Contacting Amey Asuti";
$message = "<div>
<b><h3>Enquiry Form | Ashclinic</h3></b>
<h4>User Details</h4>
<p>
For Whom : $radios_whoom <br>
Does the person in question already have a hearing aid:$radios_person <br>
Did the doctor recommend hearing aids?
: $radios_doctor <br>
Has a hearing test been conducted by a doctor?
: $radios_hearing <br>
How soon should the hearing loss be improved?
: $radios_improved <br>
How important is a discreet design?
:$radios_important<br>
Which hearing situations are difficult?
:$radios_situations<br>
How much does the hearing loss restrict the daily life?
:$radios_restrictd<br>
Does the affected person have tinnitus?
:$radios_tinnitus<br>
What has prevented you from getting hearing aids sooner?
:$radios_prevented<br>
To evaluate your best possible affordability plan, please tell us in which income group you belong (income per month).
:$radios_affordability<br>
How old is the person in question?
:$Yes<br>
Please enter your Area PIN code:
:$PIN_CODE<br>
email:$email<br>
Gender:$Mr-ms<br>
Full name : $fname<br>
Mobile or phone no :$mno<br>
comment:$Comment
</p>
</div>";
$to = 'ronak@initfusion.com';
$body = '<html>
<body>
<div><br />
<b> '.$message.'</b><br />
</div>
</body>
</html>
';
$header = "From: brijesh@initfusion.com";
//$header .= "CC: sales@primelifespace.com";
$headers .= "MIME-Version: 1.0" . "\r\n";
$headers .= "Content-type: text/html; charset=iso-8859-1" . "\r\n";
$status = mail($to,$subject,$body,$headers);
?>
<script>
window.location = "https://ashclinic.bluetick.co.in/";
</script>
<?php
?>