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<html lang="en">
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<head>
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<meta charset="utf-8">
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<meta http-equiv="X-UA-Compatible" content="IE=edge">
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<meta name="viewport" content="width=device-width, initial-scale=1">
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<meta name="description" content="CURA Healthcare Service; (678) 813-1KMS">
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<meta name="robots" content="noindex">
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<title>CURA Healthcare Service</title> <!-- Bootstrap Core CSS -->
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<link href="https://cdnjs.cloudflare.com/ajax/libs/twitter-bootstrap/3.3.7/css/bootstrap.min.css" rel="stylesheet">
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<link href="https://cdnjs.cloudflare.com/ajax/libs/bootstrap-datepicker/1.6.4/css/bootstrap-datepicker.min.css" rel="stylesheet"> <!-- Custom CSS -->
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<link href="https://katalon-demo-cura.herokuapp.com//css/theme.css" rel="stylesheet"> <!-- Custom Fonts -->
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<link href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/4.7.0/css/font-awesome.min.css" rel="stylesheet" type="text/css">
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<link href="https://fonts.googleapis.com/css?family=Source+Sans+Pro:300,400,700,300italic,400italic,700italic" rel="stylesheet" type="text/css"> <!-- HTML5 Shim and Respond.js IE8 support of HTML5 elements and media queries --> <!-- WARNING: Respond.js doesn't work if you view the page via file:// --> <!--[if lt IE 9]>
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<script src="https://oss.maxcdn.com/libs/html5shiv/3.7.0/html5shiv.js"></script>
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<script src="https://oss.maxcdn.com/libs/respond.js/1.4.2/respond.min.js"></script>
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<![endif]-->
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</head>
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<body> <!-- Navigation --> <a id="menu-toggle" href="#" class="btn btn-dark btn-lg toggle"><i class="fa fa-bars"></i></a>
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<nav id="sidebar-wrapper">
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<ul class="sidebar-nav"> <a id="menu-close" href="#" class="btn btn-light btn-lg pull-right toggle"><i class="fa fa-times"></i></a>
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<li class="sidebar-brand"> <a href="./" onclick="$('#menu-close').click();">CURA Healthcare</a> </li>
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<li> <a href="./" onclick="$('#menu-close').click();">Home</a> </li>
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<li> <a href="history.php#history" onclick="$('#menu-close').click();">History</a> </li>
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<li> <a href="profile.php#profile" onclick="$('#menu-close').click();">Profile</a> </li>
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<li> <a href="authenticate.php?logout" onclick="$('#menu-close').click();">Logout</a> </li>
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</ul>
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</nav> <!-- Header -->
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<header id="top" class="header">
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<div class="text-vertical-center">
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<h1>CURA Healthcare Service</h1>
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<h3>We Care About Your Health</h3>
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<br> <a id="btn-make-appointment" href="./index.php#appointment" class="btn btn-dark btn-lg">Make Appointment</a>
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</div>
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</header>
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<section id="appointment" class="section bg-primary">
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<div class="container">
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<div class="row">
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<div class="col-sm-12 text-center">
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<h2>Make Appointment</h2>
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<hr class="small">
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</div>
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<form class="form-horizontal" action="https://katalon-demo-cura.herokuapp.com/appointment.php#summary" method="post">
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<div class="form-group"> <label for="combo_facility" class="col-sm-offset-3 col-sm-2 control-label">Facility</label>
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<div class="col-sm-4"> <select id="combo_facility" name="facility" class="form-control"> <option value="Tokyo CURA Healthcare Center">Tokyo CURA Healthcare Center</option> <option value="Hongkong CURA Healthcare Center">Hongkong CURA Healthcare Center</option> <option value="Seoul CURA Healthcare Center">Seoul CURA Healthcare Center</option> </select>
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</div>
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</div>
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<div class="form-group">
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<div class="col-sm-offset-5 col-sm-4"> <label for="chk_hospotal_readmission" class="checkbox-inline"> <input type="checkbox" id="chk_hospotal_readmission" name="hospital_readmission" value="Yes"> Apply for hospital readmission </label>
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</div>
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</div>
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<div class="form-group"> <label class="col-sm-offset-3 col-sm-2 control-label">Healthcare Program</label>
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<div class="col-sm-4"> <label class="radio-inline"> <input type="radio" name="programs" id="radio_program_medicare" value="Medicare" checked> Medicare </label> <label class="radio-inline"> <input type="radio" name="programs" id="radio_program_medicaid" value="Medicaid"> Medicaid </label> <label class="radio-inline"> <input type="radio" name="programs" id="radio_program_none" value="None"> None </label>
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</div>
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</div>
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<div class="form-group"> <label for="txt_visit_date" class="col-sm-offset-3 col-sm-2 control-label">Visit Date (Required)</label>
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<div class="col-sm-4">
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<div class="input-group date" data-provide="datepicker" data-date-format="dd/mm/yyyy">
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<input type="text" class="form-control" id="txt_visit_date" name="visit_date" placeholder="dd/mm/yyyy" autocomplete="off" required>
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<div class="input-group-addon"> <span class="glyphicon glyphicon-calendar"></span>
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</div>
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</div>
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</div>
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</div>
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<div class="form-group"> <label for="txt_comment" class="col-sm-offset-3 col-sm-2 control-label">Comment</label>
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<div class="col-sm-4"> <textarea class="form-control" id="txt_comment" name="comment" placeholder="Comment" rows="10"></textarea>
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</div>
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</div>
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<div class="form-group">
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<div class="col-sm-offset-5 col-sm-4"> <button id="btn-book-appointment" type="submit" class="btn btn-default">Book Appointment</button>
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</div>
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</div>
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</form>
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</div>
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</div>
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</section> <!-- Footer -->
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<footer>
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<div class="container">
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<div class="row">
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<div class="col-lg-10 col-lg-offset-1 text-center">
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<h4><strong>CURA Healthcare Service</strong> </h4>
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<p>Atlanta 550 Pharr Road NE Suite 525<br>Atlanta, GA 30305</p>
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<ul class="list-unstyled">
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<li><i class="fa fa-phone fa-fw"></i> (678) 813-1KMS</li>
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<li><i class="fa fa-envelope-o fa-fw"></i> <a href="mailto:info@katalon.com">info@katalon.com</a> </li>
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</ul>
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<br>
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<ul class="list-inline">
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<li> <a href="#"><i class="fa fa-facebook fa-fw fa-3x"></i></a> </li>
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<li> <a href="#"><i class="fa fa-twitter fa-fw fa-3x"></i></a> </li>
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<li> <a href="#"><i class="fa fa-dribbble fa-fw fa-3x"></i></a> </li>
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</ul>
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<hr class="small">
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<p class="text-muted">Copyright © CURA Healthcare Service 2023</p>
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</div>
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</div>
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</div> <a id="to-top" href="#top" class="btn btn-dark btn-lg" style="display: block; position: fixed; overflow: hidden; height: 45.406px; padding: 9.87087px 15.7934px; margin: 0px; width: 56.2639px; opacity: 0.987087;"><i class="fa fa-chevron-up fa-fw fa-1x"></i></a>
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</footer>
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<script src="https://cdnjs.cloudflare.com/ajax/libs/jquery/1.11.3/jquery.min.js"></script>
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<script src="https://cdnjs.cloudflare.com/ajax/libs/twitter-bootstrap/3.3.7/js/bootstrap.min.js"></script>
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<script src="https://cdnjs.cloudflare.com/ajax/libs/bootstrap-datepicker/1.6.4/js/bootstrap-datepicker.min.js"></script>
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<script src="https://katalon-demo-cura.herokuapp.com//js/theme.js"></script>
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<div class="datepicker datepicker-dropdown dropdown-menu datepicker-orient-left datepicker-orient-top" style="top: 523px; left: 443.664px; display: block;">
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<div class="datepicker-days" style="display: block;">
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<table class="table-condensed">
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<thead>
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<tr>
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<th colspan="7" class="datepicker-title" style="display: none;"></th>
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</tr>
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<tr>
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<th class="prev" style="visibility: visible;">«</th>
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<th colspan="5" class="datepicker-switch">December 2023</th>
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<th class="next" style="visibility: visible;">»</th>
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</tr>
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<tr>
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<th class="dow">Su</th>
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<th class="dow">Mo</th>
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<th class="dow">Tu</th>
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<th class="dow">We</th>
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<th class="dow">Th</th>
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<th class="dow">Fr</th>
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<th class="dow">Sa</th>
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</tr>
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</thead>
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<tbody>
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<tr>
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<td class="old day">26</td>
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<td class="old day">27</td>
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<td class="old day">28</td>
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<td class="old day">29</td>
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<td class="old day">30</td>
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<td class="day">1</td>
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<td class="day">2</td>
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</tr>
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<tr>
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<td class="day">3</td>
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<td class="day">4</td>
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<td class="day">5</td>
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<td class="day">6</td>
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<td class="day">7</td>
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<td class="day">8</td>
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<td class="day">9</td>
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</tr>
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<tr>
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<td class="day">10</td>
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<td class="day">11</td>
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<td class="day">12</td>
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<td class="day">13</td>
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<td class="day">14</td>
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<td class="day">15</td>
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<td class="day">16</td>
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</tr>
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<tr>
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<td class="active day">17</td>
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<td class="day">18</td>
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<td class="day">19</td>
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<td class="day">20</td>
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<td class="day">21</td>
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<td class="day">22</td>
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<td class="day">23</td>
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</tr>
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<tr>
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<td class="day">24</td>
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<td class="day">25</td>
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<td class="day">26</td>
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<td class="day">27</td>
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<td class="day">28</td>
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<td class="day">29</td>
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<td class="day">30</td>
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</tr>
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<tr>
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<td class="day">31</td>
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<td class="new day">1</td>
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<td class="new day">2</td>
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<td class="new day">3</td>
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<td class="new day">4</td>
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<td class="new day">5</td>
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<td class="new day">6</td>
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</tr>
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</tbody>
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<tfoot>
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<tr>
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<th colspan="7" class="today" style="display: none;">Today</th>
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</tr>
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<tr>
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<th colspan="7" class="clear" style="display: none;">Clear</th>
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</tr>
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</tfoot>
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</table>
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</div>
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<div class="datepicker-months" style="display: none;">
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<table class="table-condensed">
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<thead>
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<tr>
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<th colspan="7" class="datepicker-title" style="display: none;"></th>
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</tr>
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<tr>
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<th class="prev" style="visibility: visible;">«</th>
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<th colspan="5" class="datepicker-switch">2023</th>
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<th class="next" style="visibility: visible;">»</th>
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</tr>
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</thead>
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<tbody>
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<tr>
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<td colspan="7"><span class="month">Jan</span><span class="month">Feb</span><span class="month">Mar</span><span class="month">Apr</span><span class="month">May</span><span class="month">Jun</span><span class="month">Jul</span><span class="month">Aug</span><span class="month">Sep</span><span class="month">Oct</span><span class="month">Nov</span><span class="month focused active">Dec</span></td>
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</tr>
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</tbody>
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<tfoot>
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<tr>
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<th colspan="7" class="today" style="display: none;">Today</th>
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</tr>
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<tr>
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<th colspan="7" class="clear" style="display: none;">Clear</th>
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</tr>
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</tfoot>
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</table>
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</div>
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<div class="datepicker-years" style="display: none;">
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<table class="table-condensed">
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<thead>
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<tr>
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<th colspan="7" class="datepicker-title" style="display: none;"></th>
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</tr>
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<tr>
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<th class="prev" style="visibility: visible;">«</th>
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<th colspan="5" class="datepicker-switch">2020-2029</th>
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<th class="next" style="visibility: visible;">»</th>
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</tr>
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</thead>
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<tbody>
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<tr>
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<td colspan="7"><span class="year old">2019</span><span class="year">2020</span><span class="year">2021</span><span class="year">2022</span><span class="year active focused">2023</span><span class="year">2024</span><span class="year">2025</span><span class="year">2026</span><span class="year">2027</span><span class="year">2028</span><span class="year">2029</span><span class="year new">2030</span></td>
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</tr>
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</tbody>
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<tfoot>
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<tr>
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<th colspan="7" class="today" style="display: none;">Today</th>
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</tr>
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<tr>
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<th colspan="7" class="clear" style="display: none;">Clear</th>
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</tr>
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</tfoot>
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</table>
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</div>
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<div class="datepicker-decades" style="display: none;">
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<table class="table-condensed">
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<thead>
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<tr>
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<th colspan="7" class="datepicker-title" style="display: none;"></th>
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</tr>
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<tr>
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<th class="prev" style="visibility: visible;">«</th>
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<th colspan="5" class="datepicker-switch">2000-2090</th>
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<th class="next" style="visibility: visible;">»</th>
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</tr>
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</thead>
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<tbody>
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<tr>
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<td colspan="7"><span class="decade old">1990</span><span class="decade">2000</span><span class="decade">2010</span><span class="decade active">2020</span><span class="decade">2030</span><span class="decade">2040</span><span class="decade">2050</span><span class="decade">2060</span><span class="decade">2070</span><span class="decade">2080</span><span class="decade">2090</span><span class="decade new">2100</span></td>
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</tr>
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</tbody>
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<tfoot>
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<tr>
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<th colspan="7" class="today" style="display: none;">Today</th>
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</tr>
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<tr>
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<th colspan="7" class="clear" style="display: none;">Clear</th>
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</tr>
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</tfoot>
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</table>
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</div>
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<div class="datepicker-centuries" style="display: none;">
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<table class="table-condensed">
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<thead>
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<tr>
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<th colspan="7" class="datepicker-title" style="display: none;"></th>
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</tr>
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<tr>
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<th class="prev" style="visibility: visible;">«</th>
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<th colspan="5" class="datepicker-switch">2000-2900</th>
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<th class="next" style="visibility: visible;">»</th>
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</tr>
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</thead>
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<tbody>
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<tr>
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<td colspan="7"><span class="century old">1900</span><span class="century active">2000</span><span class="century">2100</span><span class="century">2200</span><span class="century">2300</span><span class="century">2400</span><span class="century">2500</span><span class="century">2600</span><span class="century">2700</span><span class="century">2800</span><span class="century">2900</span><span class="century new">3000</span></td>
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</tr>
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</tbody>
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<tfoot>
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<tr>
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<th colspan="7" class="today" style="display: none;">Today</th>
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</tr>
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<tr>
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<th colspan="7" class="clear" style="display: none;">Clear</th>
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</tr>
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</tfoot>
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</table>
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</div>
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</div>
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</body>
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</html>
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