Ok, so I got two tables to work but I have many more that I am populating from one HTML form - I tried adding the third table in the same way I did the second and I get an error:
"Error: Column count doesn't match value count at row 1"
I cannot find the error...any ideas? Thanks.
<?php
$con = mysql_connect("localhost","root","");
if (!$con)
{
die('Could not connect: ' . mysql_error());
}
mysql_select_db("samplephr", $con);
$Patient_ID=mysql_real_escape_string($_POST['Patient_ID']);
$Patient_First_Name=mysql_real_escape_string($_POST['Patient_First_Name']);
$Patient_Middle_Name=mysql_real_escape_string($_POST['Patient_Last_Name']);
$Patient_Last_Name=mysql_real_escape_string($_POST['Patient_Last_Name']);
$Patient_email=mysql_real_escape_string($_POST['Patient_email']);
$Patient_DOB=mysql_real_escape_string($_POST['Patient_DOB']);
$Patient_Sex=mysql_real_escape_string($_POST['Patient_Sex']);
$Patient_Street_Address1=mysql_real_escape_string($_POST['Patient_Street_Address1']);
$Patient_Street_Address2=mysql_real_escape_string($_POST['Patient_Street_Address2']);
$Patient_City=mysql_real_escape_string($_POST['Patient_City']);
$Patient_State=mysql_real_escape_string($_POST['Patient_State']);
$Patient_Zip=mysql_real_escape_string($_POST['Patient_Zip']);
$Patient_Blood_Type=mysql_real_escape_string($_POST['Patient_Blood_Type']);
$Patient_Language=mysql_real_escape_string($_POST['Patient_Language']);
$sql="INSERT INTO patient (Patient_ID,Patient_First_Name,Patient_Middle_Name,Patient_Last_Name,Patient_email,Patient_DOB,Patient_Sex,Patient_Street_Address1,Patient_Street_Address2,Patient_City,Patient_State,Patient_Zip,Patient_Blood_Type,Patient_Language) VALUES ('$Patient_ID','$Patient_First_Name','$Patient_Middle_Name','$Patient_Last_Name','$Patient_email','$Patient_DOB','$Patient_Sex','$Patient_Street_Address1','$Patient_Street_Address2','$Patient_City','$Patient_State','$Patient_Zip','$Patient_Blood_Type','$Patient_Language')";
if (!mysql_query($sql,$con)) {
die('Error: ' . mysql_error());
}
$Ins_Provider_Name=mysql_real_escape_string($_POST['Ins_Provider_Name']);
$Ins_Provider_Address1=mysql_real_escape_string($_POST['Ins_Provider_Address1']);
$Ins_Provider_Address2=mysql_real_escape_string($_POST['Ins_Provider_Address2']);
$Ins_Provider_City=mysql_real_escape_string($_POST['Ins_Provider_City']);
$Ins_Provider_State=mysql_real_escape_string($_POST['Ins_Provider_State']);
$Ins_Provider_Zip=mysql_real_escape_string($_POST['Ins_Provider_Zip']);
$Ins_Provider_Phone=mysql_real_escape_string($_POST['Ins_Provider_Phone']);
$Ins_Provider_Fax=mysql_real_escape_string($_POST['Ins_Provider_Fax']);
$sql="INSERT INTO insurance (Ins_Provider_Name,Ins_Provider_Address1,Ins_Provider_Address2,Ins_Provider_City,Ins_Provider_State,Ins_Provider_Zip,Ins_Provider_Phone,Ins_Provider_Fax) VALUES ('$Ins_Provider_Name','$Ins_Provider_Address1','$Ins_Provider_Address2','$Ins_Provider_City','$Ins_Provider_State','$Ins_Provider_Zip','$Ins_Provider_Phone','$Ins_Provider_Fax')";
if (!mysql_query($sql,$con)) {
die('Error: ' . mysql_error());
}
$PCP_First_Name=mysql_real_escape_string($_POST['PCP_First_Name']);
$PCP_Last_Name=mysql_real_escape_string($_POST['PCP_Last_Name']);
$PCP_Address1=mysql_real_escape_string($_POST['PCP_Address1']);
$PCP_Address2=mysql_real_escape_string($_POST['PCP_Address2']);
$PCP_City=mysql_real_escape_string($_POST['PCP_City']);
$PCP_State=mysql_real_escape_string($_POST['PCP_State']);
$PCP_Zip=mysql_real_escape_string($_POST['PCP_Zip']);
$PCP_Phone=mysql_real_escape_string($_POST['PCP_Phone']);
$PCP_Fax=mysql_real_escape_string($_POST['PCP_Fax']);
$PCP_Email=mysql_real_escape_string($_POST['PCP_Email']);
$sql="INSERT INTO primarycarephysician (PCP_First_Name,PCP_Last_Name,PCP_Address1,PCP_Address2,PCP_City,PCP_State,PCP_Zip,PCP_Phone,PCP_Fax,PCP_Email) VALUES ('$PCP_First_Name','$PCP_Last_Name','$PCP_Address1','$PCP_Address2','$PCP_City','$PCP_Zip','$PCP_Phone','$PCP_Fax','$PCP_Email')";
if (!mysql_query($sql,$con)) {
die('Error: ' . mysql_error());
}
echo "The form data was successfully added to your database.";
mysql_close($con);
?>