PHP/MySQL Form Database Processing

This project was awarded to rudydelhi for $34 USD.

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Project Budget
$30 - $100 USD
Total Bids
Project Description

I have an HTML form built for customers to input their data for their online orders. It is a prescription form that each customer needs to fill out and include a file upload of a copy of their doctors prescription to my database. I will also need an admin section with a unsername and Password function where I can log on to query all of the orders in the data base by each field in the form. (Example: Search by first name, by Order number, by date the prescription form was filled out, and so on...) I will also need to be able to edit/update each form in case there are any changes I must make to any information that the customer has input. I will also need the admin query form to have a couple other fields in it that the customer will not be able to access when filling out the form. For example, when I pull up each prescription form, I can manually input prescription information from the doctor into a text area, Place a check in a checkbox of how many refills are allowed, check a checkbox that is a YES OR NO if the vet approved the prescription or not with a date and time that it was approved. I can also program these extra boxes into the form if needed. I already have the main form programmed and I need someone to help me link the fields to input the data a MYSQL database using PHP and build the admin query section. After each customer fills out the form, I would also like it to send a confirmation email to them letting them know the form has sent the data.

## Deliverables

1) Complete and fully-functional working program(s) in executable form as well as complete source code of all work done.

2) Deliverables must be in ready-to-run condition, as follows (depending on the nature of the deliverables):

a) For web sites or other server-side deliverables intended to only ever exist in one place in the Buyer's environment--Deliverables must be installed by the Seller in ready-to-run condition in the Buyer's environment.

b) For all others including desktop software or software the buyer intends to distribute: A software installation package that will install the software in ready-to-run condition on the platform(s) specified in this bid request.

3) All deliverables will be considered "work made for hire" under U.S. Copyright law. Buyer will receive exclusive and complete copyrights to all work purchased. (No GPL, GNU, 3rd party components, etc. unless all copyright ramifications are explained AND AGREED TO by the buyer on the site per the coder's Seller Legal Agreement).

## Platform

PHP/MySQL All versions of Mozilla FireFox and Internet Explorer.

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