<?php require 'includes/header.php'; ?>
<main class="main">

  <!-- Page Title -->
  <div class="page-title" data-aos="fade">
    <div class="container">
      <nav class="breadcrumbs">
        <ol>
          <li><a href="index.php">Home</a></li>
          <li class="current">Contact Us</li>
        </ol>
      </nav>
    </div>
  </div>

  <section id="contact" class="contact section">
    <div class="container sub-header-titel aos-init aos-animate" data-aos="fade-up">
      <h2>Contact Us</h2>
    </div>
    <br><br>

    <div class="container" data-aos="fade-up" data-aos-delay="100">
      <div class="row gy-4">

        <!-- Contact Info -->
        <div class="col-lg-5">
          <div class="info-wrap">
            <h2 style="font-weight: bold; text-align: center; padding: 10px 0;">Quick Details</h2>

            <div class="info-item d-flex" data-aos="fade-up" data-aos-delay="200">
              <i class="bi bi-geo-alt flex-shrink-0"></i>
              <div>
                <h3>Conference Secretariat :</h3>
                <p>
                 Dr. Rajesh Kapoor Suruchi Eye Hospital, U-123,<br>
Sector-4, Airoli, Navi Mumbai
                </p>
              </div>
            </div><!-- End Info Item -->

            

         

          

            <!-- Optional Map -->
            <!--
            <iframe src="https://www.google.com/maps/embed?pb=..."
              width="100%" height="270" style="border:0;" allowfullscreen="" loading="lazy"
              referrerpolicy="no-referrer-when-downgrade"></iframe>
            -->
          </div>
        </div>

        <!-- Contact Form -->
        <div class="col-lg-7">
          <form action="ddb.php" method="post" class="info-wrap">
            <div class="row gy-4">

              <div class="col-md-6">
                <div class="input-box">
                  <input id="name" name="name" type="text" required class="form-control" placeholder="Full Name">
                </div>
              </div>

              <div class="col-md-6">
                <div class="input-box">
                  <input type="tel" id="mobile" name="phone" class="form-control" required placeholder="Phone">
                </div>
              </div>

              <div class="col-md-6">
                <div class="input-box">
                  <input id="email" name="email" type="email" class="form-control" required placeholder="Email">
                </div>
              </div>

              <div class="col-md-6">
                <div class="input-box">
                  <input type="text" id="subject" name="subject" class="form-control" required placeholder="Subject">
                </div>
              </div>

              <div class="col-md-12">
                <div class="input-box">
                  <textarea name="msg" rows="6" id="message" class="form-control" required placeholder="Type your message..."></textarea>
                </div>
              </div>

              <div class="col-md-12 text-center">
                <div class="input-box">
                  <button type="submit" class="btn btn-primary mt-3" style="background: #e63939; border: none;">
                    Send
                  </button>
                </div>
              </div>

            </div>
          </form>
        </div><!-- End Contact Form -->

      </div>
    </div>
  </section><!-- /Contact Section -->

</main>

<?php require 'includes/footer.php'; ?>
