Patient Feedback To Doctor Design

patient feedback to doctor design column (label text)

description

label name

input type

input type name

default table value referred

patient id

patients id

idlabel

text box

idtxtbox

blank

feedback v

first name

first name of the patient last name of the patient middle name of the patient doctor’s id day of dob

fnlabel

text box

fntxtbox

blank

feedback v

lnlabel

text box

lntxtbox

blank

feedback v

mnlabel

text box

mntxtbox

blank

feedback v

docidlabel daylabel

docidtxtbox daylistbox

blank day

feedback v feedback n

month

month of dob

monthlabel

monthlistbox

month

feedback v

year

year of dob

yearlabel

yearlistbox

year

feedback n

subject

subject of the feedback comments provided by the patient name of the city email id of the patient submits the feedback form resets the form.

subjectlabel

text box dropdown list box dropdown list box dropdown list box text box

unametxtbox

blank

feedback v

commentlabel

text area

commenttxtare a

blank

feedback v

citylabel

text box

citytxtbox

blank

feedback v

maillabel

text box

mailtxtbox

blank

feedback v

submitlabel

button

submitbutton

na

feedback n

resetlabel

button

resetbutton

na

feedback n

last name middle name

doctor id day

comments city email id

submit reset

d s