Server IP : 103.233.192.212 / Your IP : 18.118.173.146 Web Server : Apache/2 System : Linux sv1.inde.co.th 3.10.0-1160.36.2.el7.x86_64 #1 SMP Wed Jul 21 11:57:15 UTC 2021 x86_64 User : sumpatuan ( 1058) PHP Version : 5.5.38 Disable Function : symlink,shell_exec,exec,proc_close,proc_open,popen,system,dl,putenv,passthru,escapeshellarg,escapeshellcmd,pcntl_exec,proc_get_status,proc_nice,proc_terminate,pclose,ini_alter,virtual,openlog,ini_restore MySQL : ON | cURL : ON | WGET : OFF | Perl : OFF | Python : OFF | Sudo : OFF | Pkexec : OFF Directory : /home/sumpatuan/domains/sumpatuan.go.th/public_html/main/ |
Upload File : |
<?php require_once('db_main.php'); ?> <!doctype html> <html lang="en"> <head> <?php include_once ("head.html"); ?> </head> <body class="bg-all animated fadeIn faster "> <?php include_once ("chatfacebook.php"); ?> <div class="container-fluid p-0 " > <div class="container bg-main fix-page mb-0 pb-0" > <?php include_once ("menu.php"); ?> </div> <!------ data ------> <div class="container bg-white fix-page mt-0 " id="data"> <div class="row"> <div class="col bg-cl-0 fcl-cl-1 bg-txt-head text-center"> ช่องทางการรับฟังความคิดเห็น </div> <div class="w-100"></div> <div class="col text-secondary p-0" > <div class="ps-4 p-2 box-link fw-300" > <a href="subEService#data" class="link-danger fw-500">E-service</a> > ช่องทางการรับฟังความคิดเห็น </div> </div> <div class="w-100"></div> <div class="col p-4 pb-5 fw-500"> <div class="mx-auto box_dataeser "> <div class="fs-30 fw-500 pb-2 text-center"><i class="fas fa-edit me-2"></i>กรอกข้อมูล ความคิดเห็น</div> <hr class="mt-2 mb-4"> <form id="form_subHelping" name="form_subHelping" action="action/save-subEService-ContactService" method="POST" enctype="multipart/form-data" > <div class="row mb-3"> <div class="col-3 m-auto text-end pe-1 lh-1">หัวข้อ</div> <div class="col-9"><input type="text" name="txt_name" class="form-control fw-300" maxlength="100" required></div> </div> <div class="row mb-3"> <div class="col-3 m-auto text-end pe-1 lh-1">ชื่อ-นามสกุล</div> <div class="col-9"><input type="text" name="txt_ct_name" class="form-control fw-300" maxlength="100" required></div> </div> <div class="row mb-3"> <div class="col-3 m-auto text-end pe-1 lh-1">เบอร์โทรศัพท์</div> <div class="col-9"><input type="text" name="txt_ct_tel" class="form-control fw-300" oninput="this.value = this.value.replace(/\D+/g, '')" minlength="9" maxlength="10" required></div> </div> <div class="row mb-3"> <div class="col-3 m-auto text-end pe-1 lh-1">E-mail<br><small class="fw-300 fs-12">* หากไม่มีอีเมล ไม่ต้องกรอก</small></div> <div class="col-9"><input type="email" name="txt_ct_email" class="form-control fw-300" maxlength="100"></div> </div> <hr class="mt-4 mb-4"> <div class="row"> <div class="col-3 m-auto text-end pe-1 lh-1">รายละเอียด<br><small class="fw-300 fs-12">ความคิดเห็น</small></div> <div class="col-9"><textarea class="form-control mt-1 fw-300" name="txt_details" rows="10" maxlength="600"></textarea></div> </div> <hr class="mt-4 mb-3"> <div class="text-center"> <div class="g-recaptcha" data-callback="enableBtn" data-sitekey="<?php echo $gg_sitekey; ?>"></div> <button type="submit" id="btn_sm" class="btn btn-dark w-100 fs-300 mt-2" disabled><i class="fas fa-paper-plane me-2" ></i> ส่งความคิดเห็น</button> </div> </form> </div> </div> <div class="w-100"></div> <div class="col bg-cl-2 text-center fcl-cl-1 fs-1" style="height:10px;"></div> </div> </div> <!------------------> <script> function enableBtn(){ $("#btn_sm").prop('disabled',false); } </script> <?php include_once ("footer.php"); ?> </div> <?php include_once ("cookie.php"); ?> </body> </html>