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<html>
<head>
<title>Enquiry | Shantam Chest & Sleep Disorders</title>
<meta name="keywords" content="">
<meta name="description" content="Enquiry | Shantam Chest & Sleep Disorders">
<meta name="viewport" content="width=device-width, initial-scale=1.0, user-scalable=no">
<?php include 'top-link.php';?>
</head>
<body>
<div id="wrap">
<?php include 'header.php';?>
<div class="container">
<section style="background:url(images/slides/abt-bg.jpg) no-repeat center; background-size:cover;">
<div class="container">
<div class="row">
<div class="col-md-12 abt-pg">
<h2>Enquiry</h2>
<p><a href="index.php">Home</a> | Enquiry</p>
</div>
</div>
</div>
</section>
<div class="make-appointment">
<div class="container">
<ul id="accordion" class="accordion">
<li>
<div class="link"><i class="fa fa-database"></i><span class="appointment-title">Make an Appointment</span> <i class="icon-chevron-down"></i> </div>
<section class="bgcolor-3">
<h2 class="mk-apt">Please call on <span>+91 8368783807 / 9971204999</span> to Book an Appointment</h2>
</section>
</li>
</ul>
</div>
</div>
<!--Start Content-->
<div class="content">
<div class="contact-us">
<div class="leave-msg dark-back">
<div class="container">
<div class="rox">
<div class="col-md-4 bg-cnt hidden-xs">
<img src="images/enquiry.png">
</div>
<div class="col-md-8">
<div class="form">
<div class="row">
<p class="success" id="success" style="display:none;"></p>
<p class="error" id="error" style="display:none;"></p>
<form name="contact_form" id="contact_form" method="post" action="#" onSubmit="return false">
<div class="col-md-6"><input type="text" data-delay="300" placeholder="Your full name" name="contact_name" id="contact_name" class="input"></div>
<div class="col-md-6"><input type="text" data-delay="300" placeholder="Mobile No" name="contact_subject" id="contact_subject" class="input"></div>
<div class="col-md-12"><input type="text" data-delay="300" placeholder="E-mail Address" name="contact_email" id="contact_email" class="input"></div>
<div class="col-md-12"><input type="text" data-delay="300" placeholder="Subject" name="contact_subject" id="contact_subject" class="input"></div>
<div class="col-md-12"><textarea data-delay="500" class="required valid" placeholder="Message" name="message" id="message"></textarea></div>
<div class="col-md-3"><input name=" " type="submit" value="Send Your Mesage" onClick="validateContact();"></div>
</form>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<?php include 'footer.php';?>