[text* name placeholder “Adınız”]
[tel* phonumber placeholder “Telefon”]
[select* servicetype”Type Of Service” “Face Lift” “Hymenoplasty” “Laser Hair Removal” “Double Chin Removal” “Rhinoplasty Surgery” “Liposuction”]
[select* staffname”Staff” “Chris Martin” “Jean Piaget” “Edward Jenner” “Paul Tournier” “Alfred Adler” “Robert Winston” “Ivan Pavlov”]
[date* date placeholder “Available on – Yyyy-Mm-Dd”]
[select start-time class:start-time “from” “8:00 am” “9:00 am” “10:00 am” “11:00 am” “12:00 pm” “1:00 pm” “2:00 pm” “3:00 pm” “4:00 pm” “5:00 pm” “6:00 pm” “7:00 pm” “8:00 pm” “9:00 pm” “10:00 pm” “11:00 pm”]
[select end-time class:end-time “to” “8:00 am” “9:00 am” “10:00 am” “11:00 am” “12:00 pm” “1:00 pm” “2:00 pm” “3:00 pm” “4:00 pm” “5:00 pm” “6:00 pm” “7:00 pm” “8:00 pm” “9:00 pm” “10:00 pm” “11:00 pm”]
[submit “Check Availability”]