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75 lines (67 loc) · 2.24 KB
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<html>
<head>
<title>Edit Contact Us Form</title>
<style>
body {
background-color: #f8f9fa;
font-family: Arial, sans-serif;
font-size: 16px;
padding: 20px;
}
h1 {
color: #343a40;
text-align: center;
}
form {
max-width: 500px;
margin: auto;
background-color: #fff;
border-radius: 5px;
padding: 20px;
}
label {
font-weight: bold;
margin-bottom: 10px;
display: block;
}
input[type="text"], input[type="email"], input[type="query"] {
width: 100%;
padding: 10px;
margin-bottom: 20px;
border-radius: 5px;
border: 1px solid #ced4da;
box-sizing: border-box;
font-size: 16px;
}
input[type="submit"] {
background-color: #4a69bb;
color: #fff;
padding: 10px 20px;
border: none;
border-radius: 5px;
cursor: pointer;
}
input[type="submit"]:hover {
background-color: #2c3e50;
}
</style>
</head>
<body>
<h1>Edit contact-us form</h1>
{% for row in rows %}
<form action="{{ url_for('editrec') }}" method="POST">
<h3 style="color:blue">Patient Id ID: {{ row['rowid']}}</h3>
<input type="hidden" name="rowid" value="{{ row['rowid'] }}">
Name<br>
<input type="text" name="name" value="{{ row['name'] }}"/><br>
Email<br>
<input type="text" name="add" value="{{row['email']}}"/><br>
Phone No.<br>
<input type="text" name="Phone" value="{{ row['Phone'] }}"/><br>
Query<br>
<input type="query" name="query" value="{{ row['query'] }}"/><br>
<input type="submit" value="Submit" /><br>
</form>
{% endfor %}
</body>
</html>