Design a form for the Patient Satisfaction Survey for a particular hos

Question

Design a form for the Patient Satisfaction Survey for a particular hospital having the following fields:

Patient's name

Patient's File number (Issued by the hospital)

Which Unit of the hospital the patient was admitted Select V (Surgery, Medicine, etc.)

Are you satisfied with overall treatment:

Very Satisfi Satisfied Not Satisfied

Are you satisfied with medical facilities in the hospital:

Very Satisfied Satisfied Not Satisfied

Overall Comments

Submit

Reset

Note : you are required judiciously choose the options for Text Box, Combo Box, Radio Button, Check Box, Buttons etc. for the respective fields required in the form

a) Submit button should enter all the fields’ data to the database.

b) Error message should be shown if a text field is left blank.

c) Reset button resets all the fields to the blank.

d) Use JavaScript to validate the fields

23 Apr 2025

Answer :

Word Count : 870

To design the Patient Satisfaction Survey form, I'll outline how the form could be structured in HTML with appropriate form controls such as text boxes, combo boxes, radio buttons, and buttons. Additionally, I'll include JavaScript code for validation, error handling, and resetting the form.

Here’s the structure:

```html
<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>Patient Satisfaction Survey</title>
<script>
// JavaScript function to validate the form
function validateForm() {
var name = document.getElementById("name").value;
var fileNumber = document.getElementById("fileNumber").value;
var unit = document.getElementById("unit").value;
var treatmentSatisfaction = document.querySelector('input[name="treatmentSatisfaction"]:checked');
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