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Home/ Questions/Q 631815
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Editorial Team
  • 0
Editorial Team
Asked: May 13, 20262026-05-13T20:00:30+00:00 2026-05-13T20:00:30+00:00

I have this code to verify whether an html text box is empty or

  • 0

I have this code to verify whether an html text box is empty or not. But I can’t figure out what common with admission time and address, that they don’t seem to work. The code is not reading them even if I have inputted a data on them:

   <html>
<head>
<title>Admission Information Sheet</title>
    <meta http-equiv="Content-Type" content="text/html; Western (ISO-8859-1)">
    <meta name="author" content=" ">
<title>
<style>
input { font-size: 16px;}
</style>
<?php include('header.php'); ?>
<div id="main_content">

</div>
<?php include('footer.php'); ?>

<table border="1" width="900" border="0" align="left" cellpadding="0" cellspacing="1" bgcolor="#CCCCCC">
<tr>
<form name="form1.1" method="POST" action="aisaction.php">

<?php

     $TELNUM = $_POST[telnum];
     $HOSPNUM = $_POST[hnum];
     $ROOMNUM = $_POST[rnum];
     $LASTNAME = $_POST[lname];
     $FIRSTNAME = $_POST[fname];
     $MIDNAME = $_POST[mname];
     $ADDRESS = $_POST[address];
     $NURSE = $_POST[nurse];

     $ADATE = $_POST[adate];
     $ADTIME = $_POST[adtym];
     $CSTAT = $_POST[cs];
     $AGE = $_POST[age];
     $BDAY = $_POST[bday];
     $SEX = $_POST[sex];


     ?>
<td>
<table width="100%" border="0" cellpadding="2" cellspacing="1" bgcolor="#FFFFFF">
<tr>
<td colspan="12" style="background:#9ACD32; color:white; border:white 1px solid; text-align: center"><strong><font size="3">ADMISSION INFORMATION SHEET</strong></td>
</tr>
<tr>


</td><br>     
<td width="54"><font size="3">Hospital #</td>
<td width="3">:</td>
<td width="168"><input type="display" name="hnum" disabled="true" value= "<?php print "$HOSPNUM";?>"><br>
         <font color="red">     
     <?php   
        if(empty($HOSPNUM))
            print "* Hospital Number required!<br>";
    ?>
</td>

<td width="41"><font size="3">Room #</td>
<td width="3">:</td>
<td width="168"><input type="display" name="rnum" disabled="true" value= "<?php print "$ROOMNUM";?>"><br>
        <font color="red">      
     <?php
            if(empty($ROOMNUM ))
            print "* Room Number required!<br>";
     ?>
</td>

<td width="67"><font size="3">Admission Date</td>
<td width="3">:</td>
<td width="168"><input type="display" name="adate" disabled="true" value= "<?php print "$ADATE";?>"><br>
        <font color="red">      
     <?php
            if(empty($ADATE))
            print "* Admission Date required!<br>";
     ?>
</td>

</tr>
<tr>
<td><font size="3">Last Name</td>
<td>:</td>
<td><input type="display" name="lname" disabled="true" value= "<?php print "$LASTNAME";?>"><br>
        <font color="red">      
     <?php
            if(empty($LASTNAME))
            print "* Last Name required!<br>";
     ?>
</td>
<td><font size="3">First Name</td>
<td>:</td>
<td><input type="display" name="fname" disabled="true" value= "<?php print "$FIRSTNAME";?>"><br>
        <font color="red">      
     <?php
            if(empty($FIRSTNAME))
            print "* First Name required!<br>";
     ?>
</td>
<td><font size="3">Middle Name</td>
<td>:</td>
<td><input type="display" name="mname" disabled="true" value= "<?php print "$MIDNAME";?>"><br>
        <font color="red">      
     <?php
            if(empty($MIDNAME))
            print "* Middle Name required!<br>";
     ?>
</td>
<td width="67"><font size="3">Admission Time</td>
<td width="3">:</td>
<td width="168"><input type="display" name="adtym" disabled="true" value= "<?php print "$ADTIME";?>"><br>
        <font color="red">      
     <?php
            if(empty($ADTIME))
            print "* Admission Time required!<br>";
     ?>
</td>
</tr>



<tr>
<td><font size="3">Civil Status</td>
<td>:</td>
<td><input type="display" name="cs" disabled="true" value= "<?php print "$CSTAT";?>"><br>
        <font color="red">      
     <?php
            if(empty($CSTAT))
            print "* Civil Status required!<br>";
     ?>
</td>
<td><font size="3">Age</td>
<td>:</td>
<td><input type="display" name="age" disabled="true" value= "<?php print "$AGE";?>"><br>
        <font color="red">      
     <?php
            if(empty($AGE))
            print "* Age required!<br>";
     ?>
</td>
<td><font size="3">Birthday</td>
<td>:</td>
<td><input type="display" name="bday" disabled="true" value= "<?php print "$BDAY";?>"><br>
        <font color="red">      
     <?php
            if(empty($BDAY))
            print "* Birthday required!<br>";
     ?>
</td>

</tr>

<tr>
<td><font size="3">Address</td>
<td>:</td>
<td><input type="display" name="address" disabled="true" value= "<?php print "$ADDRESS";?>"><br>
        <font color="red">      
     <?php
            if(empty($ADDRESS))
            print "* Address required!<br>";
     ?>
</td>
<td><font size="3">Telephone #</td>
<td>:</td>
<td><input type="display" name="telnum" disabled="true" value= "<?php print "$TELNUM";?>"></td>
    <font color="red">      
     <?php
            if(empty($TELNUM))
            print "* Address required!<br>";
     ?>


<td width="23"><font size="3">Sex</td>
<td width="3">:</td>
<td width="174"><input type="display" name="sex" disabled="true" value= "<?php print "$SEX";?>"><br>
        <font color="red">      
     <?php
            if(empty($SEX))
            print "* Gender required!<br>";
     ?>
</td>
</tr>

<tr>
<td><font size="3">Pls. Check</td>
<td>:</td>
<td><input name="stats1" type="checkbox" id="SSS" value="SSS">SSS</td>
<td><font size="3"></td>
<td>:</td>
<td><input name="stats1" type="checkbox" id="nonmed" value="NonMedicare">Non Medicare</td>

<td><font size="3"></td>
<td>:</td>
<td><input name="stats1" type="checkbox" id="sh" value="stockholder">Stockholder</td>
</tr>


<tr>
<td><font size="3"></td>
<td></td>
<td><input name="stats1" type="checkbox" id="gsis" value="GSIS">GSIS</td>
<td><font size="3"></td>
<td></td>
<td><input name="stats1" type="checkbox" id="senior" value="seniorcitizen">Senior-Citizen</td>


<tr>
<td><font size="3"></td>
<td></td>
<td><input name="stats1" type="checkbox" id="dep" value="dependent">Dependent</td>
<td><font size="3"></td>
<td></td>
<td><input name="stats1" type="checkbox" id="emp" value="employee">Employee</td>

</tr>

<tr>
<td><font size="3">Attending Nurse</td>
<td>:</td>
<td><input type="display" name="nurse" disabled="true" value= "<?php print "$NURSE";?>"><br>
        <font color="red">      
     <?php
            if(empty($NURSE))
            print "* Admitting/Attending Nurse required!<br>";
     ?>
</td>


</tr>


<tr>

<td>&nbsp;</td>
<td>&nbsp;</td>

<td><input type="button" value="Back" onClick="history.go(-1);return true;">
<?php
        $val1 = $_POST['NURSE'];
        if($_POST['NURSE'] != "")
        {
    ?>
    <form action="aisaction.php" method="POST" target="_window">
            <input type="hidden" name="submit" value="yes">
            <input type="submit" value="submit">
    </form>
    <?php
        }
    ?>

</td>
</td>

</tr>
</table>
</td>


</form>
</tr>
</table>
</head>
</html>
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1 Answer

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  1. Editorial Team
    Editorial Team
    2026-05-13T20:00:30+00:00Added an answer on May 13, 2026 at 8:00 pm

    What’s up with the second <form> containing just a hidden input and a submit button? That submit button belongs in the outer form. (Forms can’t be nested, anyhow. No forms inside of other forms!)

    Make this:

    <form action="aisaction.php" method="POST" target="_window">
        <input type="hidden" name="submit" value="yes">
        <input type="submit" value="submit">
    </form>
    

    into this:

    <input type="hidden" name="submit" value="yes">
    <input type="submit" value="submit">
    
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