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POST send.php

<form method="post" action="send.php" class="contact-form" novalidate="novalidate">
  <div class="row">
    <div class="col span_6">
      <div class="input">
        <label for="name">Nom / Prénom </label>
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          <input type="text" name="name" id="name" class="input-field-item required" aria-required="true">
        </div>
      </div>
    </div>
    <div class="col span_6">
      <div class="input">
        <label for="email">E-mail</label>
        <div class="input-field">
          <input type="text" name="email" id="email" class="input-field-item required" aria-required="true">
        </div>
      </div>
    </div>
  </div>
  <div class="input">
    <label for="message">Message</label>
    <div class="input-field">
      <textarea name="message" id="message" cols="30" rows="5" class="input-field-item required" aria-required="true"></textarea>
    </div>
  </div>
  <div class="center">
    <input type="submit" value="Envoyer" class="btn btn-bordered">
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</form>

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LABORATOIRE D'ANALYSES MÉDICALES


DR MOHAMED HASSAN GADDOUR BIOCHIMIE HEMATOLOGIE HEMOSTASE IMMUNOLOGIE SEROLOGIE
ALLERGOLOGIE BACTERIOLOGIE MYCOLOGIE

Dynamic Lab Pro Solutions

Résultats Clinique Résultats Médecin Résultats Patient


CONTACTS



Tunisie, Sfax,
Route de Taniour km 7 -Chihia- A côté de Pharmacie Wassef Abdelkefi

+216 74846512
>+216 99846292

Laboratoire.hsangaddour@gmail.com
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