Untitled

<html>

    <head>

	<?php

// php code to Insert data into mysql database from input text
if(isset($_POST['insert']))
{
    $hostname = "localhost";
    $username = "root";
    $password = "";
    $databaseName = "clientinfo";

    // get values form input text and number

    $name = $_POST['name'];
    $age = $_POST['age'];
    $sickness = $_POST['sickness'];
    $medicine = $_POST['medicine'];
    $paid = $_POST['paid'];

    // connect to mysql database using mysqli

    $connect = mysqli_connect($hostname, $username, $password, $databaseName);

    // mysql query to insert data

    $query = "INSERT INTO `clients`(`Name`, `Age`, `Sickness`, `Medicine`, `Paid`) VALUES ('$name','$age','$sickness','$medicine','$paid')";

    $result = mysqli_query($connect,$query);

    // check if mysql query successful

    if($result)
    {
        echo 'Data Inserted';
    }

    else{
        echo 'Data Not Inserted';
    }

    mysqli_free_result($result);
    mysqli_close($connect);
}

?>

        <title> PHP INSERT DATA </title>

        <meta charset="UTF-8">

        <meta name="viewport" content="width=device-width, initial-scale=1.0">

    </head>

    <body>

        <form action="clients.php" method="post">

            <input type="text" name="name" required placeholder="Name"><br><br>

            <input type="number" name="age" required placeholder="Age" min="1" max="200"><br><br>

            <input type="text" name="sickness" required placeholder="Sickness"><br><br>

            <input type="text" name="medicine" required placeholder="Medicine"><br><br>

            <input type="number" name="paid" required placeholder="Paid" min="10" max="1000000000"><br><br>

            <input type="submit" name="insert" value="Add Data To Database">

        </form>

</body>

</html>