<!doctype html>
<html lang="zxx">

    <?php
include 'include/head.php'
?>

<body>
    <!--==================== Header ====================-->
        <?php
include 'include/header.php'
?>
    <!-- Sub header -->
    <section class="space sub-header">
        <div class="container container-custom">
            <div class="row">
                <div class="col-md-6">
                    <div class="sub-header_content">
                        <p>CONTACT US</p>
                        <h3>Drop your message for any info or question.</h3>
                        <span><i>Home / Contact Us</i></span>
                    </div>
                </div>
                <div class="col-md-6">
                    <div class="sub-header_main">
                        <h2>Contact Us</h2>
                    </div>
                </div>
            </div>
        </div>
    </section>
    <!--//End Sub header -->
    <!--//End Header -->
    <!--==================== Contact Us ====================-->
    <section class="space">
        <div class="container container-custom">
            <div class="row">
                <div class="col-md-5">
                    <iframe width="100%" height="100%" src="https://www.google.com/maps/embed?pb=!1m18!1m12!1m3!1d3429.5676239879854!2d76.7886180746614!3d30.730553485739673!2m3!1f0!2f0!3f0!3m2!1i1024!2i768!4f13.1!3m3!1m2!1s0x390fed9016936b71%3A0x6e13edb668b82c74!2sDr%20Jatinder%20Singla%20%7C%20Director%20Orthopedics%20%26%20Joint%20Replacement%20MAX%20Hospital%20Mohali%20%7C%20Best%20Knee%20Surgeon!5e0!3m2!1sen!2sin!4v1705921571149!5m2!1sen!2sin" style="border:0;" allowfullscreen="" loading="lazy" referrerpolicy="no-referrer-when-downgrade"></iframe>
                    
                </div>
                <div class="col-md-7">
                    <div class="get-in-touch get-in-touch-style2">
                        <img src="images/contact-form-bg.png" class="img-fluid get-in-bg" alt="#">
                        <h3>Get in Touch with Us</h3>
                        <form action="https://api.web3forms.com/submit" method="POST" id="form">
                            <!-- REQUIRED: Your Access key here. Don't worry this can be public -->
                            <!-- Create your Access key here: https://web3forms.com/ -->
                            <input type="hidden" name="apikey" value="YOUR_ACCESS_KEY_HERE">
                            <div class="row">
                                <div class="col-md-6">
                                    <div class="form-group">
                                        <input type="text" class="form-control" name="first name"
                                            placeholder="First Name" required>
                                        <i class="far fa-user"></i>
                                    </div>
                                </div>
                                <div class="col-md-6">
                                    <div class="form-group">
                                        <input type="text" class="form-control" name="last name" placeholder="Last Name"
                                            required>
                                        <i class="far fa-user"></i>
                                    </div>
                                </div>
                            </div>
                            <div class="row">
                                <div class="col-md-6">
                                    <div class="form-group">
                                        <input type="email" class="form-control" name="email address"
                                            placeholder="Your Email" required>
                                        <i class="far fa-envelope"></i>
                                    </div>
                                </div>
                                <div class="col-md-6">
                                    <div class="form-group">
                                        <input type="number" class="form-control" name="phone number"
                                            placeholder="Your Phone Number" required>
                                        <i class="fas fa-phone"></i>
                                    </div>
                                </div>
                            </div>
                            <div class="row">
                                <div class="col-md-12">
                                    <div class="form-group textarea-icon">
                                        <textarea class="form-control" name="message" required
                                            placeholder="Your Message" id="" rows="3"></textarea>
                                        <i class="far fa-envelope"></i>
                                        <button type="submit" class="btn btn-success">BOOK NOW</button>
                                    </div>
                                </div>
                            </div>
                            <div id="result" class="text-white"></div>
                        </form>
                    </div>
                </div>
            </div>
        </div>
    </section>
    <!--//End Contact Us -->
    <!--==================== Map ====================-->
    
    <!--//End Map -->
     
    <!--==================== Footer ====================-->
      <?php
include 'include/footer.php'
?>
</body>

</html>