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<section class="contact-section p_relative"> <div class="bg-layer"></div> <div class="pattern-layer"> <div class="pattern-1" style="background-image: url(assets/images/shape/shape-7.png);"></div> <div class="pattern-2" style="background-image: url(assets/images/shape/shape-8.png);"></div> </div> <div class="auto-container"> <div class="sec-title centred light mb_45"> <span class="sub-title"> Help</span> <h2>Need a Doctor for Check-up? <br /></h2> </div> <div class="support-box p_relative centred"> <div class="icon-box"><img src="assets/images/icons/icon-2.png" alt=""></div> <h3>Call: <a href="tel:8377061536">+91 8377061536</a></h3> </div> <div class="row clearfix"> <div class="col-lg-4 col-md-12 col-sm-12 form-column"> <div class="form-inner"> <h3>Get Appointment If You <span>Need Cosultation</span></h3> <form action="#" method="post" class="default-form"> <div class="form-group"> <input type="text" name="name" placeholder="Your Name" required=""> </div> <div class="form-group"> <input type="email" name="email" placeholder="Email" required=""> </div> <div class="form-group"> <div class="icon"><i class="far fa-angle-down"></i></div> <input type="text" name="date" placeholder="Appointment date" id="datepicker"> </div> <div class="form-group message-btn"> <button type="submit" class="theme-btn btn-two">Make Appointment</button> </div> </form> </div> </div> <div class="col-lg-8 col-md-12 col-sm-12 video-column"> <div class="video-inner" style="background-image: url(<?php echo $wspath?>assets/img/ward.jpg);"> <!--<div class="video-btn">--> <!-- <a href="#" class="lightbox-image" data-caption=""><i class="fas fa-play"></i></a>--> <!--</div>--> </div> </div> </div> </div> </section>