// JavaScript Document

function check(feedback)
{
	/* doctor name start */
	if(document.feedback.Patient_Name.value=="")
		{
			alert("Please insert proper First name");
			document.feedback.Patient_Name.focus();
			return false;
		}
		

	if(document.feedback.Age.value=="")
		{
			alert("Please insert proper Age");
			document.feedback.Age.focus();
			return false;
		}
	if(document.feedback.Age.value!="")
		{
			 var codeinput=document.feedback.Age.value.toString();
			 for(i=0; i < codeinput.length; i++)
			 {
	  			 var ch=codeinput.charAt(i);
	   			 if(ch < "0" || ch > "9")
	 			  {
	   				alert("Age should be in number");
					document.feedback.Age.value="";
					document.feedback.Age.focus();
					return false;
	 			  }
			  }
		}  
	
		
	if(document.feedback.Permanent_Address.value=="")
	{
	alert("Please Enter your Permanent Address");
	document.feedback.Permanent_Address.focus();
	return false;
	}
	
if(document.feedback.City.value=="")
		{
			alert("Please insert proper City");
			document.feedback.City.focus();
			return false;
		}
		
	if(document.feedback.City.value!="")
		{
			var firstinputstr=document.feedback.City.value.toString();
			for(i=0; i < firstinputstr.length; i++)
			{
				var ch=firstinputstr.charAt(i);
				if(ch < "A" || ch > "z") {
				alert("Characters only in City");
				document.feedback.City.value="";
				document.feedback.City.focus();
				return false;
				}
			}
		}	
		

if(document.feedback.State.value=="")
		{
			alert("Please insert proper State");
			document.feedback.State.focus();
			return false;
		}
		
	if(document.feedback.State.value!="")
		{
			var firstinputstr=document.feedback.State.value.toString();
			for(i=0; i < firstinputstr.length; i++)
			{
				var ch=firstinputstr.charAt(i);
				if(ch < "A" || ch > "z") {
				alert("Characters only in State");
				document.feedback.State.value="";
				document.feedback.State.focus();
				return false;
				}
			}
		}	
		
if(document.feedback.Zip.value=="")
	{
	alert("Please enter proper Zip code");
	document.feedback.Zip.focus();
	return false;
	}
	
	
	if(document.feedback.Zip.value!="")
	{
		var inputstr=document.feedback.Zip.value.toString();
		for(i=0; i < inputstr.length; i++)
		{
			var ch=inputstr.charAt(i);
			if(ch < "0" || ch > "9") {
			alert("Zip code should be in number");
			document.feedback.Zip.value="";
			document.feedback.Zip.focus();
			return false;
			}
		}
	}	
	

/* phone no start */

	if(document.feedback.intcode.value=="")
	{
	alert("Please enter proper Initial code");
	document.feedback.intcode.focus();
	return false;
	}
	
	
	if(document.feedback.intcode.value!="")
	{
		var inputstr=document.feedback.intcode.value.toString();
		for(i=0; i < inputstr.length; i++)
		{
			var ch=inputstr.charAt(i);
			if(ch < "0" || ch > "9") {
			alert("Initial code should be in number");
			document.feedback.intcode.value="";
			document.feedback.intcode.focus();
			return false;
			}
		}
	}	
	
	
	if(document.feedback.areacode.value=="")
	{
		alert("Please enter proper area code");
		document.feedback.areacode.focus();
		return false;
	}
	
	if(document.feedback.areacode.value!="")
	{
		var inputstr=document.feedback.areacode.value.toString();
		for(i=0; i < inputstr.length; i++)
		{
			var ch=inputstr.charAt(i);
			if(ch < "0" || ch > "9") {
			alert("Areacode should be in number");
			document.feedback.areacode.value="";
			document.feedback.areacode.focus();
			return false;
			}
		}
	}	
	
	if(document.feedback.phone.value=="")
	{
	alert("Please enter telephone no");
	document.feedback.phone.focus();
	return false;
	}
	
	if(document.feedback.phone.value!="")
	{
	var inputstr=document.feedback.phone.value.toString();
	for(i=0; i < inputstr.length; i++)
		{
			var ch=inputstr.charAt(i);
			if(ch < "0" || ch > "9") {
			alert("Telephone no should be in number");
			document.feedback.phone.value="";
			document.feedback.phone.focus();
			return false;
			}
		}
	}


if(document.feedback.Business_Tel_Intl_Code.value=="")
	{
	alert("Please enter proper Business Initial code");
	document.feedback.Business_Tel_Intl_Code.focus();
	return false;
	}
	
	
	if(document.feedback.Business_Tel_Intl_Code.value!="")
	{
		var inputstr=document.feedback.Business_Tel_Intl_Code.value.toString();
		for(i=0; i < inputstr.length; i++)
		{
			var ch=inputstr.charAt(i);
			if(ch < "0" || ch > "9") {
			alert("Business Initial code should be in number");
			document.feedback.Business_Tel_Intl_Code.value="";
			document.feedback.Business_Tel_Intl_Code.focus();
			return false;
			}
		}
	}	
	
	
	if(document.feedback.Business_Tel_Area_Code.value=="")
	{
		alert("Please enter proper Business area code");
		document.feedback.Business_Tel_Area_Code.focus();
		return false;
	}
	
	if(document.feedback.Business_Tel_Area_Code.value!="")
	{
		var inputstr=document.feedback.Business_Tel_Area_Code.value.toString();
		for(i=0; i < inputstr.length; i++)
		{
			var ch=inputstr.charAt(i);
			if(ch < "0" || ch > "9") {
			alert("Business areacode should be in number");
			document.feedback.Business_Tel_Area_Code.value="";
			document.feedback.Business_Tel_Area_Code.focus();
			return false;
			}
		}
	}	
	
	if(document.feedback.Business_Tel.value=="")
	{
	alert("Please enter Business telephone no");
	document.feedback.Business_Tel.focus();
	return false;
	}
	
	if(document.feedback.Business_Tel.value!="")
	{
	var inputstr=document.feedback.Business_Tel.value.toString();
	for(i=0; i < inputstr.length; i++)
		{
			var ch=inputstr.charAt(i);
			if(ch < "0" || ch > "9") {
			alert("Business telephone no should be in number");
			document.feedback.Business_Tel.value="";
			document.feedback.Business_Tel.focus();
			return false;
			}
		}
	}

/* phone no end */


	if(document.feedback.email_address.value=="")
		{
			alert("Please enter your Email ID");
			document.feedback.email_address.focus();
			return false;
		}
		
	if(document.feedback.email_address1.value=="")
		{
			alert("Please enter business Email ID");
			document.feedback.email_address1.focus();
			return false;
		}
		
		
/* put fax code */
		
	if(document.feedback.address.value=="")
	{
		alert("Please Enter your local address");
		document.feedback.address.focus();
		return false;
	}	
	
	if(document.feedback.Emergency_Contact_Name.value=="")
	{
		alert("Please Enter your Emergency Contact Name");
		document.feedback.Emergency_Contact_Name.focus();
		return false;
	}	
	
	if(document.feedback.Contacts_Tel.value=="")
	{
	alert("Please enter proper Contacts telephone no");
	document.feedback.Contacts_Tel.focus();
	return false;
	}
	
	if(document.feedback.Contacts_Tel.value!="")
	{
	var inputstr=document.feedback.Contacts_Tel.value.toString();
	for(i=0; i < inputstr.length; i++)
		{
			var ch=inputstr.charAt(i);
			if(ch < "0" || ch > "9") {
			alert("Telephone no should be in number");
			document.feedback.Contacts_Tel.value="";
			document.feedback.Contacts_Tel.focus();
			return false;
			}
		}
	}
	
	/* referring phy info start */
	if(document.feedback.Refering_Physician_Name.value=="")
	{
	alert("Please enter proper Refering telephone no");
	document.feedback.Refering_Physician_Name.focus();
	return false;
	}
	
	if(document.feedback.Refering_Physician_Tel.value=="")
	{
	alert("Please enter Refering Physician Telephone no");
	document.feedback.Refering_Physician_Tel.focus();
	return false;
	}
	
	if(document.feedback.Refering_Physician_Tel.value!="")
	{
	var inputstr=document.feedback.Refering_Physician_Tel.value.toString();
	for(i=0; i < inputstr.length; i++)
		{
			var ch=inputstr.charAt(i);
			if(ch < "0" || ch > "9") {
			alert("Refering Physician Telephone should be in number");
			document.feedback.Refering_Physician_Tel.value="";
			document.feedback.Refering_Physician_Tel.focus();
			return false;
			}
		}
	}
	
	
	if(document.feedback.Refering_Physician_Email.value=="")
		{
			alert("Please enter proper Refering Email ID");
			document.feedback.Refering_Physician_Email.focus();
			return false;
		}
	
	/* referring phy info end */

}	

function EmailValidation(Element)
	{
		
		var stremail=Element.value;
		//alert(stremail);
      var emailchar=/^([\w-]+(?:\.[\w-]+)*)@((?:[\w-]+\.)*\w[\w-]{0,66})\.([a-z]{2,6}(?:\.[a-z]{2})?)$/;
	 // alert(emailchar.test(stremail));
      if(emailchar.test(stremail))
      	{
		  return true;
        }
	      else 
    	{
   			 alert("Please enter the valid email address");
    		 Element.focus();
    		 return false;
   	    }	
  }