<html> <head> <meta charset="utf-8"> <link rel="stylesheet" type="text/css" href="style.css"> </head> <body> <div class="login-root"> <div class="box-root flex-flex flex-direction--column" style="min-height: 100vh;flex-grow: 1;"> <div class="loginbackground box-background--white padding-top--64"> <div class="loginbackground-gridContainer"> <div class="box-root flex-flex" style="grid-area: top / start / 8 / end;"> <div class="box-root" style="background-image: linear-gradient(white 0%, rgb(247, 250, 252) 33%); flex-grow: 1;"> </div> </div> <div class="box-root flex-flex" style="grid-area: 4 / 2 / auto / 5;"> <div class="box-root box-divider--light-all-2 animationLeftRight tans3s" style="flex-grow: 1;"></div> </div> <div class="box-root flex-flex" style="grid-area: 6 / start / auto / 2;"> <div class="box-root box-background--blue800" style="flex-grow: 1;"></div> </div> <div class="box-root flex-flex" style="grid-area: 7 / start / auto / 4;"> <div class="box-root box-background--blue animationLeftRight" style="flex-grow: 1;"></div> </div> <div class="box-root flex-flex" style="grid-area: 8 / 4 / auto / 6;"> <div class="box-root box-background--gray100 animationLeftRight tans3s" style="flex-grow: 1;"></div> </div> <div class="box-root flex-flex" style="grid-area: 2 / 15 / auto / end;"> <div class="box-root box-background--cyan200 animationRightLeft tans4s" style="flex-grow: 1;"></div> </div> <div class="box-root flex-flex" style="grid-area: 3 / 14 / auto / end;"> <div class="box-root box-background--blue animationRightLeft" style="flex-grow: 1;"></div> </div> <div class="box-root flex-flex" style="grid-area: 4 / 17 / auto / 20;"> <div class="box-root box-background--gray100 animationRightLeft tans4s" style="flex-grow: 1;"></div> </div> <div class="box-root flex-flex" style="grid-area: 5 / 14 / auto / 17;"> <div class="box-root box-divider--light-all-2 animationRightLeft tans3s" style="flex-grow: 1;"></div> </div> </div> </div> <div class="box-root padding-top--24 flex-flex flex-direction--column" style="flex-grow: 1; z-index: 9;"> <div class="box-root padding-top--48 padding-bottom--24 flex-flex flex-justifyContent--center"> <h1><a href="http://blog.stackfindover.com/" rel="dofollow">HOSPITAL ADMIN SIGN-UP</a></h1> </div> <div class="formbg-outer"> <div class="formbg"> <div class="formbg-inner padding-horizontal--48"> <span class="padding-bottom--15">Sign up to your account</span> <form id="contactForm2" action=""> <div class="alert">Signed UP</div> <div class="field padding-bottom--24"> <label for="name">Name</label> <input type="text" name="email" id="name2"> </div> <div class="field padding-bottom--24"> <label for="email">Email</label> <input type="email" name="email" id="email2"> </div> <div class="field padding-bottom--24"> <div class="grid--50-50"> <label for="password">Password</label> </div> <input type="password" name="password" id="password2"> </div> <div class="field padding-bottom--24"> <label for="mobile">Mobile Number</label> <input type="mobile" name="mobile" id="mobile2"> </div> <div class="field padding-bottom--24"> <label for="city">City/Town/Village</label> <input type="city" name="city" id="city2"> </div> <div class="field padding-bottom--24"> <label for="district">District</label> <input type="district" name="district" id="district2"> </div> <div class="field field-checkbox padding-bottom--24 flex-flex align-center"> </div> <div class="field padding-bottom--24"> <input type="submit" name="submit" value="Continue"> </div> <div class="field"> </div> </form> </div> </div> <div class="footer-link padding-top--24"> <div class="listing padding-top--24 padding-bottom--24 flex-flex center-center"> </div> </div> </div> </div> </div> </div> <script src="https://cdnjs.cloudflare.com/ajax/libs/firebase/7.14.1-0/firebase.js"></script> <script src="hospitalsu.js"></script> </body> </html>