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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>Aadhaar Card Appointment - Post Office</title>
<style>
body {
font-family: Arial, sans-serif;
background-color: #f4f4f4;
padding: 20px;
}
.container {
max-width: 600px;
margin: auto;
background-color: #fff;
padding: 20px;
box-shadow: 0 0 10px rgba(0,0,0,0.1);
border-radius: 10px;
}
h2 {
text-align: center;
}
label {
font-weight: bold;
}
input, select, button {
width: 100%;
padding: 10px;
margin: 10px 0;
border: 1px solid #ccc;
border-radius: 5px;
}
button {
background-color: #007BFF;
color: white;
cursor: pointer;
}
button:hover {
background-color: #0056b3;
}
</style>
</head>
<body>
<div class="container">
<h2>Book Your Aadhaar Appointment</h2>
<form action="submit_appointment.php" method="POST">
<!-- Personal Information Section -->
<label for="name">Full Name:</label>
<input type="text" id="name" name="name" required>
<label for="mobile">Mobile Number:</label>
<input type="tel" id="mobile" name="mobile" pattern="[0-9]{10}" required>
<label for="email">Email Address (optional):</label>
<input type="email" id="email" name="email">
<label for="aadhar">Aadhaar Number:</label>
<input type="text" id="aadhar" name="aadhar" pattern="[0-9]{12}" required>
<!-- Service Type -->
<label for="service">Service Type:</label>
<select id="service" name="service" required>
<option value="new">New Aadhaar Enrollment</option>
<option value="update">Update Existing Aadhaar</option>
<option value="biometric">Biometric Update</option>
</select>
<!-- Appointment Date and Time -->
<label for="date">Preferred Appointment Date:</label>
<input type="date" id="date" name="date" required>
<label for="time">Preferred Appointment Time:</label>
<input type="time" id="time" name="time" required>
<!-- Submit Button -->
<button type="submit">Book Appointment</button>
</form>
</div>
</body>
</html>
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