<?php include('header.php');?>

      <!-- Title Bar -->
      <div class="pbmit-title-bar-wrapper">
         <div class="container">
            <div class="pbmit-title-bar-content">
               <div class="pbmit-title-bar-content-inner">
                  <div class="pbmit-tbar">
                     <div class="pbmit-tbar-inner container">
                        <h1 class="pbmit-tbar-title">Contact Us</h1>
                     </div>
                  </div>
                  <div class="pbmit-breadcrumb">
                     <div class="pbmit-breadcrumb-inner">
                        <span><a title="" href="#" class="home"><span>Home</span></a></span>
                        <span class="sep"><i class="pbmit-base-icon-angle-double-right"></i></span>
                        <span><span class="post-root post post-post current-item">Contact Us</span></span>
                     </div>
                  </div>
               </div>
            </div> 
         </div> 
      </div>
      <!-- Title Bar End-->

      <!-- Contact Us Content -->
      <div class="page-content">   

         <!-- Contact -->
         <section class="contact-section">
            <div>
               <iframe src="https://www.google.com/maps/embed?pb=!1m18!1m12!1m3!1d3749.8602063296653!2d73.7703535752291!3d19.97238042322154!2m3!1f0!2f0!3f0!3m2!1i1024!2i768!4f13.1!3m3!1m2!1s0x3bddeb3f10627acb%3A0x54433991f1c1175f!2sLife%20Care%20Hospitals!5e0!3m2!1sen!2sin!4v1692355389265!5m2!1sen!2sin" style="border:0;" allowfullscreen="" loading="lazy" referrerpolicy="no-referrer-when-downgrade"></iframe>
            </div>
         </section>

         <section class="contact-section-bg">
            <div class="container">
               <div class="contact-main-section">
                  <div class="row g-0">
                     <div class="col-md-4">
                        <div class="contact-section-left"> 
                           <h3 class="mb-4">Get In Touch</h3>  
                           <div class="pbmit-ihbox-style-3">
                              <div class="pbmit-ihbox-box d-flex">
                                 <div class="pbmit-ihbox-icon">
                                    <div class="pbmit-ihbox-icon-wrapper">
                                       <i class="pbmit-base-icon-phone"></i>
                                    </div>
                                 </div>
                                 <div class="pbmit-ihbox-contents">
                                    <h2 class="pbmit-element-title">Phone Number</h2>
                                    <div><a href="tel:0253 6716666">0253 6716666</a><br><a href="tel:9225669717">9225669717</a> </div>
                                 </div>
                              </div>
                           </div> 
                           <div class="pbmit-ihbox-style-3">
                              <div class="pbmit-ihbox-box d-flex">
                                 <div class="pbmit-ihbox-icon">
                                    <div class="pbmit-ihbox-icon-wrapper">
                                       <i class="pbmit-base-icon-location"></i>
                                    </div>
                                 </div>
                                 <div class="pbmit-ihbox-contents">
                                    <h2 class="pbmit-element-title">Our Location</h2>
                                    <div>Lekha Nagar,New<br> Nashik, Nashik - <br>422009</div>
                                 </div>
                              </div>
                           </div> 
                           <div class="pbmit-ihbox-style-3">
                              <div class="pbmit-ihbox-box d-flex">
                                 <div class="pbmit-ihbox-icon">
                                    <div class="pbmit-ihbox-icon-wrapper">
                                       <i class="pbmit-base-icon-mail-alt"></i>
                                    </div>
                                 </div>
                                 <div class="pbmit-ihbox-contents">
                                    <h2 class="pbmit-element-title">Email Address</h2>
                                    <div><a href="mailto:info@lifecare-hospitals.in" class="__cf_email__" >info@lifecare-hospitals.in</a>
                                    <a href="mailto:corporate@lifecare-hospitals.in" class="__cf_email__" >corporate@lifecare-hospitals.in</a></div>
                                 </div>
                              </div>
                           </div> 
                           <ul class="pbmit-social-links">
                              <li class="pbmit-social-li pbmit-social-facebook ">
                                 <a href="#" target="_blank">
                                    <span><i class="pbmit-base-icon-facebook-squared"></i></span>
                                 </a>
                              </li>
                              <li class="pbmit-social-li pbmit-social-twitter ">
                                 <a href="#" target="_blank">
                                    <span><i class="pbmit-base-icon-twitter"></i></span>
                                 </a>
                              </li>
                              <li class="pbmit-social-li pbmit-social-linkedin ">
                                 <a href="#" target="_blank">
                                    <span><i class="pbmit-base-icon-linkedin-squared"></i></span>
                                 </a>
                              </li>
                              <li class="pbmit-social-li pbmit-social-youtube ">
                                 <a href="#" target="_blank">
                                    <span><i class="pbmit-base-icon-youtube-play"></i></span>
                                 </a>
                              </li>
                           </ul>                                                  
                        </div>
                     </div>
                     <div class="col-md-8">
                        <div class="contact-section-right">
                           <h3>Contact Us</h3>
                           <p>Feel Free to Contact us any time. We will get back to you as soon as we can!</p>
                           <!--<form class="contact-form"  method="post" id="contact-form" action="https://cardioly-demo.pbminfotech.com/html-demo/send.php">-->
                             <form class="contact-form"  method="post" id="myForm" >
                                <div id="check1"></div>
                              <div class="row">
                                 <div class="col-md-6 col-sm-12">
                                    <div class="contact-form-section">
                                       <input type="text" class="form-control" placeholder="Name" name="name" id="name">
                                    </div>
                                 </div>
                                 <div class="col-md-6 col-sm-12">
                                    <div class="contact-form-section">
                                       <input type="email" class="form-control" placeholder="Email" name="email" id="email">
                                    </div>
                                 </div>
                                 <div class="col-md-6 col-sm-12">
                                    <div class="contact-form-section">
                                       <input type="text" class="form-control" placeholder="Phone" name="phone" id="phone">
                                    </div>
                                 </div>
                                 <div class="col-md-6 col-sm-12">
                                    <div class="contact-form-section">
                                       <input type="text" class="form-control" placeholder="Subject" name="subject" id="subject">
                                    </div>
                                 </div>
                                 <div class="col-md-12 col-sm-12">
                                    <div class="contact-form-section">
                                       <textarea class="form-control" name="message"  id="message"rows="4" placeholder="Message" style="height: 100px;" ></textarea>
                                    </div>
                                 </div>
                                 <div class="col-md-12 col-sm-12 pb-4">
                                    <button type="submit"  id="btn_submit" name="submit" value="submit" class="pbmit-btn pbmit-btn-hover-secondary">
                                       <i class=""></i>
                                       Send Message
                                    </button>
                                 </div>
                                 <!--<div class="col-md-12 col-lg-12 message-status"></div>-->
                              </div>
                           </form> 
                        </div>
                     </div>
                  </div>
               </div>
            </div>
         </section>
         <!-- Contact End -->

      </div>
      <!-- Contact Us Content End -->
      
      <?php include('footer.php');?>
      
      
        
<script src="https://ajax.googleapis.com/ajax/libs/jquery/3.5.1/jquery.min.js"></script>
<script type="text/javascript">


    $(document).ready(function(){
      
        $('#myForm').submit(function(e){
            
            e.preventDefault();
            var name = $('#name').val();
            var email = $('#email').val();
            var phone = $('#phone').val();
            var subject = $('#subject').val();
            var message = $('#message').val();
            var error = false;
            var flg=1;
       //alert(name);alert(email);alert(subject);
             var name_regex="^[a-zA-Z\\s]*$";
            var email_regex =/\b(^(\S+@).+((\.com)|(\.net)|(\.edu)|(\.mil)|(\.gov)|(\.org)|(\.info)|(\.in)|(\.biz)|(\.aero)|(\.coop)|(\.museum)|(\.name)|(\.pro)|(\..{2,2}))$)\b/gi;
            var mobile_regex=/\d{10}/;
        if(!name.match(name_regex) || name == "")
        {
          $('#check1').html('** Please Enter your Name **').css( "color", "red");
          $("#name").focus();
          var error = true;
          return false;
        }
        
         
         if (!email.match(email_regex)|| email == "") 
        {
          $('#check1').html('** Please Enter Your Email Id **').css( "color", "red");
          $("#email").focus();
          var error = true;
          return false;
        }
        
     
        
        if( phone == "")
        {
          $('#check1').html('** Please Select your Phone **').css( "color", "red");
          $("#phone").focus();
          var error = true;
          return false;
        }
     
        if( subject == "")
        {
          $('#check1').html('** Please Select your Subject **').css( "color", "red");
          $("#subject").focus();
          var error = true;
          return false;
        }
     
         if (message == "") 
        {
          $('#check1').html('** Please Enter Your Message **').css( "color", "red");
          $("#message").focus();
          var error = true;
          return false;
        } 
        if(error!=true)
            {
                $('#btn_submit').attr({'disabled' : 'true', 'value' : 'Sending...' });  
               var form = $('#myForm')[0];
                var formData = new FormData(form);
                $.ajax({
                    url: "contact_valid.php",

                    type: "POST",             
                    data: formData,
                    contentType: false,       
                    cache: false,             
                    processData:false, 
                    success: function(data) {
                    
                       
                        if(data=='sent')
                        {
                            $('#btn_submit').removeAttr('disabled').attr('value', 'Sent')
                            $('#check1').html('** Thank You For Contacting Us,We Will Contact You Soon.. **').css( "color", "green");
                             $("#myForm").get(0).reset();
                            
                        }
                        else
                        {
                                $('#btn_submit').removeAttr('disabled').attr('value', 'Retry');
                            $('#check1').html(data).css("color","red");
                        }
                    }
                });
                return false;
            }
            else
            {
                alert("error");
            }
        });
    });
</script>
