I'm trying to validate user input in php. This code will check if the values are null or not. If it is null, this will require the user to input the values that are null. When all the text boxes in the html form that came before this. This code will show the submit button, and that submit button will save the inputted data into the mysql database. But the problem is that the value that is saved is
zero zero and
zero, what might be the cause of this?
<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
$NURSE = $_POST[nurse];
$TELNUM = $_POST[telnum];
$HOSPNUM = $_POST[hnum];
$ROOMNUM = $_POST[rnum];
$LASTNAME = $_POST[lname];
$FIRSTNAME = $_POST[fname];
$MIDNAME = $_POST[mname];
$AD = $_POST[ad];
$ADATE = $_POST[adate];
$ADTIME = $_POST[adtime];
$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($MIDNAME))
print "* Middle Name required!<br>";
?>
</td>
<td><font size="3">Admit time</td>
<td>:</td>
<td><input type="display" name="mname" disabled="true" value= "<?php print "$ADTIME";?>"><br>
<font color="red">
<?php
if(empty($ADTIME))
print "* Adtime required!<br>";
?>
</td>
</tr>
<tr>
<td><font size="3">Civil Status</td>
<td>:</td>
<td><input type="display" name="cs" disabled="true" value= "<?php print "$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($BDAY))
print "* Birthday required!<br>";
?>
</td>
</tr>
<tr>
<td><font size="3">Address</td>
<td>:</td>
<td><input type="display" name="address" disabled="true" value= "<?php print "$AD";?>"><br>
<font color="red">
<?php
if(empty($AD))
print "* Address required!<br>";
?>
</td>
<td><font size="3">Telephone #</td>
<td>:</td>
<td><input type="display" name="telnum" disabled="true" value= "<?php print "$TELNUM";?>"></td>
<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> </td>
<td> </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>
