Hello i'm tying to save information from a form to a database but am having some problems.
I';m getting the following error:
Parse error: parse error, unexpected T_STRING in /u20/drmarcve/eforms/your_patient_info.php on line 179
Heres the code from that section:
INSERT INTO Patients (date, patient_id, name, address, city, state, zip, email, sex, age, birthdate, marital_status,
occupation, employer, employer_address, employer_phone, spouse_name, spouse_birthdate, spouses_social, spouses_employer,
referral, account_responsible, relationship_to_patient, insurance_company, group_no, additional_insurance, subscribers_name,
sub_birthdate, social_security, relation_to_patient, insurance_company2, group_no2, home, work, ext, cell, spouses_work,
best_time_to_call, emer_name, emer_relationship, emer_home, emer_work, todays_visit, former_dentist, den_city, last_visit,
last_xray, dh1, dh2, dh3, dh4, dh5, dh6, dh7, dh8, dh9, dh10, dh11, dh12, dh13, dh14, dh15, dh16, dh17, dh18, dh19, dh20,
dh21, dh22, dh23, dh24, dh25, dh26, floss, brush, physician, last_phy_visit, hh1, hh2, hh3, hh4, hh5, hh6, hh7, hh8, hh9,
hh10, hh11, hh12, hh13, hh14, hh15, hh16, hh17, hh18, hh19, hh20, hh21, hh22, hh23, hh24, hh25, hh26, hh27, hh28, hh29,
hh30, hh31, hh32, hh33, hh34, hh35, hh36, hh37, hh38, hh39, hh40, hh41, hh42, hh43, hh44, hh45, hh46, hh47, hh48, hh49,
hh50, hh51, hh52, hh53, hh54, hh55, hh56, hh57, due_date, nursing, birth_control, medications, pharmacy, phar_phone, aspirin,
barbiturates, codeine, iodine, latex, anesthetic, penicillin, sulfa, other, other_allergies, other_allergies2) VALUES
('$todaymonth $todayday, $todayyear','$hic','$patient','$address','$city','$state','$zip','$email','$sex','$age',
'$patientbirthm $patientbirthd, $patientbirthyear','$martial','$job','$employer','$employerstreet $employercity',
'$employerphone','$spouse','$spousebirthm $spousebirthd, $spousebirthy','$spousesocial','$spouseemployer','$referral',
'$accountresponsible','$relationshiptopatient','$insurance','$group','$additionalinsurance','$subscriber',
'$birthdaymonth $birthdayday, $birthdayyear','$socialsecurity','patientrelationship','$insurancecompany','$groupnumber',
'$homephone','$workphone','$extension','$cellphone','$spouseswork','$timetoreach','$emergencyname','$emergencyrelationship',
'$emergencyphone','$emergencyworkphone','$visit','$formerdentist','$dentistcity','$dentalvisitm $dentalvisitd, $dentalvisity'
,'$xraym $xrayd, $xrayy','$dh1','$dh2','$dh3','$dh4','$dh5','$dh6','$dh7','$dh8','$dh9','$dh10','$dh11','$dh12','$dh13',
'$dh14','$dh15','$dh16','$dh17','$dh18','$dh19','$dh20','$dh21','$dh22','$dh23','$dh24','$dh25','$dh26','$floss','$brush',
'$doctor','$doctorm $doctord, $doctory','$hh1','$hh2','$hh3','$hh4','$hh5','$hh6','$hh7','$hh8','$hh9','$hh10','$hh11',
'$hh12','$hh13','$hh14','$hh15','$hh16','$hh17','$hh18','$hh19','$hh20','$hh21','$hh22','$hh23','$hh24','$hh25','$hh26',
'$hh27','$hh28','$hh29','$hh30','$hh31','$hh32','$hh33','$hh34','$hh35','$hh36','$hh37','$hh38','$hh39','$hh40','$hh41',
'$hh42','$hh43','$hh44','$hh45','$hh46','$hh47','$hh48','$hh49','$hh50','$hh51','$hh52','$hh53','$hh54','$hh55','$hh56',
'$hh57','$due_datem $due_dated, $duedatey','$nursing','$birth_control','$medications','$pharmancy_name','$pharmacy_phone',
'$aspirin','$Barbiturates','$Codeine','$Iodine','$latex','$Local_Anesthetic','$Penicillin','$Sulfa','$other_allergies2',
'NULL/VOID','NULL/VOID');
If anyone see's somthing i'm missing it would be great if you could point it out. thanks. By the way... i'm not a php programmer so if its somthing obvious i'm sorry.
