'; } $lastName=trim($lastName); if(empty($lastName)) { $ok=false; echo 'The last name can not be blank
'; } if(empty($gender)) { $ok=false; echo 'Please select male or female
'; } $birthdate=mktime(0,0,0,$month,$day,$year); //if not a valid date, such as Sept. 31, or Feb. 29 in a non-leapyear, it wraps over to next mont, ie Oct. 1 or March 1. $format1="$month/$day/$year"; $format2=date("n/j/Y",$birthdate); if($format1!=$format2) { $ok=false; echo 'The date you entered is not a valid date
'; } if($ok) echo 'The information is complete.
'; //can be entered in database } else echo 'Please complete all information and press submit
'; ?>


Have you had any of the following:


'; if(isset($firstName)) echo '$firstName='.$firstName.'
'; else echo 'NO value for $firstName
'; if(isset($lastName)) echo '$lastName='.$lastName.'
'; else echo 'NO value for $lastName
'; if(isset($gender)) echo '$gender='.$gender.'
'; else echo 'NO value for $gender
'; echo "Birthdate=$month/$day/$year
"; $age=$curYear-$year; echo 'Age='.$age.'
'; echo "Previous conditions: "; if(isset($asthma)) echo 'asthma '; if(isset($hypertension)) echo 'hypertension '; if(isset($cancer)) echo 'cancer '; echo "
Reason for visit: $reason
"; ?>