// JavaScript Document

function check(feedback)
{
	if(document.feedback.first_name.value=="")
		{
			alert("Please insert proper First name");
			document.feedback.first_name.focus();
			return false;
		}
	if(document.feedback.first_name.value!="")
		{
			var firstinputstr=document.feedback.first_name.value.toString();
			for(i=0; i < firstinputstr.length; i++)
			{
				var ch=firstinputstr.charAt(i);
				if(ch < "A" || ch > "z") {
				alert("Characters only in First name");
				document.feedback.first_name.value="";
				document.feedback.first_name.focus();
				return false;
				}
			}
		}	
		
	if(document.feedback.middle_name.value=="")
		{
			alert("Please insert proper middle name");
			document.feedback.middle_name.focus();
			return false;
		}
	if(document.feedback.middle_name.value!="")
		{
			var firstinputstr=document.feedback.middle_name.value.toString();
			for(i=0; i < firstinputstr.length; i++)
			{
				var ch=firstinputstr.charAt(i);
				if(ch < "A" || ch > "z") {
				alert("Characters only in middle name");
				document.feedback.middle_name.value="";
				document.feedback.middle_name.focus();
				return false;
				}
			}
		}	
		
	if(document.feedback.last_name.value=="")
		{
			alert("Please insert proper last name");
			document.feedback.last_name.focus();
			return false;
		}
	if(document.feedback.last_name.value!="")
		{
			var lastinputstr=document.feedback.last_name.value.toString();
			for(i=0; i < lastinputstr.length; i++)
			{
				var ch=lastinputstr.charAt(i);
				if(ch < "A" || ch > "z") {
				alert("Characters only in last name");
				document.feedback.last_name.value="";
				document.feedback.last_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.email.value=="")
		{
			alert("Please enter Email ID");
			document.feedback.email.focus();
			return false;
		}
		
	/* telephone detail 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("numbers only in Initial code");
			document.feedback.intcode.value="";
			document.feedback.intcode.focus();
			return false;
			}
		}
	}	
	
	if(document.feedback.Country_code.value=="")
	{
		alert("Please enter proper Country code");
		document.feedback.Country_code.focus();
		return false;
	}
	
	if(document.feedback.Country_code.value!="")
	{
		var inputstr=document.feedback.Country_code.value.toString();
		for(i=0; i < inputstr.length; i++)
		{
			var ch=inputstr.charAt(i);
			if(ch < "0" || ch > "9") {
			alert("numbers only in Country code");
			document.feedback.Country_code.value="";
			document.feedback.Country_code.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("numbers only in areacode");
			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("numbers only telephone no");
			document.feedback.phone.value="";
			document.feedback.phone.focus();
			return false;
			}
		}
	}
	/* telephone detail end */	
	
	/* mobile no detail start */
	if(document.feedback.mobileintcode.value=="")
	{
	alert("Please enter proper Initial code");
	document.feedback.mobileintcode.focus();
	return false;
	}
	
	
	if(document.feedback.mobileintcode.value!="")
	{
		var inputstr=document.feedback.mobileintcode.value.toString();
		for(i=0; i < inputstr.length; i++)
		{
			var ch=inputstr.charAt(i);
			if(ch < "0" || ch > "9") {
			alert("numbers only in Initial code");
			document.feedback.mobileintcode.value="";
			document.feedback.mobileintcode.focus();
			return false;
			}
		}
	}	
	
	if(document.feedback.mobileCountry_code.value=="")
	{
		alert("Please enter proper Country code");
		document.feedback.mobileCountry_code.focus();
		return false;
	}
	
	if(document.feedback.mobileCountry_code.value!="")
	{
		var inputstr=document.feedback.mobileCountry_code.value.toString();
		for(i=0; i < inputstr.length; i++)
		{
			var ch=inputstr.charAt(i);
			if(ch < "0" || ch > "9") {
			alert("numbers only in Country code");
			document.feedback.mobileCountry_code.value="";
			document.feedback.mobileCountry_code.focus();
			return false;
			}
		}
	}	
	
	if(document.feedback.mobileareacode.value=="")
	{
		alert("Please enter proper area code");
		document.feedback.mobileareacode.focus();
		return false;
	}
	
	if(document.feedback.mobileareacode.value!="")
	{
		var inputstr=document.feedback.mobileareacode.value.toString();
		for(i=0; i < inputstr.length; i++)
		{
			var ch=inputstr.charAt(i);
			if(ch < "0" || ch > "9") {
			alert("numbers only in  area code");
			document.feedback.mobileareacode.value="";
			document.feedback.mobileareacode.focus();
			return false;
			}
		}
	}	
	
	if(document.feedback.mobile.value=="")
	{
	alert("Please enter mobile no");
	document.feedback.mobile.focus();
	return false;
	}
	
	if(document.feedback.mobile.value!="")
	{
	var inputstr=document.feedback.mobile.value.toString();
	for(i=0; i < inputstr.length; i++)
		{
			var ch=inputstr.charAt(i);
			if(ch < "0" || ch > "9") {
			alert("numbers only in mobile no");
			document.feedback.mobile.value="";
			document.feedback.mobile.focus();
			return false;
			}
		}
	}
	/* mobile no detail end */	
	
	if(document.feedback.address.value=="")
	{
		alert("Please Enter your contact address");
		document.feedback.address.focus();
		return false;
	}		

	
	/* city detail start */	
	if(document.feedback.city.value=="")
	{
			alert("Please Enter your city");
			document.feedback.city.focus();
			return false;
	}
	
	if(document.feedback.city.value!="")
	{
	 var cityinput=document.feedback.city.value.toString();
	 for(i=0; i < cityinput.length; i++)
	 	{
	 		var ch=cityinput.charAt(i);
			if(ch < "A" || ch >"z")
			{
				alert("charcater only in city");
				document.feedback.city.value="";
				document.feedback.city.focus();
				return false;
			}
		}	
	}
	/* city detail end */	
	
	/* state detail start*/	
	if(document.feedback.state.value=="")
	{
	alert("Please Enter your state");
	document.feedback.state.focus();
	return false;
	}
	
if(document.feedback.state.value!="")
	{
	 var cityinput=document.feedback.state.value.toString();
	 for(i=0; i < cityinput.length; i++)
	 	{
	 		var ch=cityinput.charAt(i);
			if(ch < "A" || ch >"z")
			{
				alert("charcater only in state");
				document.feedback.state.value="";
				document.feedback.state.focus();
				return false;
			}
		}	
	}
	/* state detail end */	
	
	
	if(document.feedback.country.value=="")
	{
		alert("Please enter proper country");
		document.feedback.country.focus();
		return false;
	}
	if(document.feedback.country.value!="")
	{
		 var cityinput=document.feedback.country.value.toString();
	 	for(i=0; i < cityinput.length; i++)
	 	{
	 		var ch=cityinput.charAt(i);
			if(ch < "A" || ch >"z")
			{
				alert("charcater only in country");
				document.feedback.country.value="";
				document.feedback.country.focus();
				return false;
			}
		}	
	}
		
	/* patients detail start */
	
	if(document.feedback.Refering_Physician_Name.value=="")
		{
			alert("Please insert proper Refering Physician First name");
			document.feedback.Refering_Physician_Name.focus();
			return false;
		}
		
	if(document.feedback.Refering_Physician_Name.value!="")
		{
			var firstinputstr=document.feedback.Refering_Physician_Name.value.toString();
			for(i=0; i < firstinputstr.length; i++)
			{
				var ch=firstinputstr.charAt(i);
				if(ch < "A" || ch > "z") {
				alert("Characters only in Refering Physician First name");
				document.feedback.Refering_Physician_Name.value="";
				document.feedback.Refering_Physician_Name.focus();
				return false;
				}
			}
		}	
		
		
	if(document.feedback.Refering_Physician_Email.value=="")
		{
			alert("Please enter Email ID");
			document.feedback.Refering_Physician_Email.focus();
			return false;
		}
		
	
	/* patients telephone detail start */
	if(document.feedback.Refering_Physician_intcode.value=="")
	{
	alert("Please enter proper Initial code");
	document.feedback.Refering_Physician_intcode.focus();
	return false;
	}
	
	
	if(document.feedback.Refering_Physician_intcode.value!="")
	{
		var inputstr=document.feedback.Refering_Physician_intcode.value.toString();
		for(i=0; i < inputstr.length; i++)
		{
			var ch=inputstr.charAt(i);
			if(ch < "0" || ch > "9") {
			alert("numbers only in Initial code");
			document.feedback.Refering_Physician_intcode.value="";
			document.feedback.Refering_Physician_intcode.focus();
			return false;
			}
		}
	}	
	
	if(document.feedback.Refering_Physician_Country_code.value=="")
	{
		alert("Please enter proper Refering Physician Country code");
		document.feedback.Refering_Physician_Country_code.focus();
		return false;
	}
	
	if(document.feedback.Refering_Physician_Country_code.value!="")
	{
		var inputstr=document.feedback.Refering_Physician_Country_code.value.toString();
		for(i=0; i < inputstr.length; i++)
		{
			var ch=inputstr.charAt(i);
			if(ch < "0" || ch > "9") {
			alert("numbers only in Refering Physician Country code");
			document.feedback.Refering_Physician_Country_code.value="";
			document.feedback.Refering_Physician_Country_code.focus();
			return false;
			}
		}
	}	
	
	if(document.feedback.Refering_Physician_areacode.value=="")
	{
		alert("Please enter proper Refering Physician area code");
		document.feedback.Refering_Physician_areacode.focus();
		return false;
	}
	
	if(document.feedback.Refering_Physician_areacode.value!="")
	{
		var inputstr=document.feedback.Refering_Physician_areacode.value.toString();
		for(i=0; i < inputstr.length; i++)
		{
			var ch=inputstr.charAt(i);
			if(ch < "0" || ch > "9") {
			alert("numbers only in Refering Physician");
			document.feedback.Refering_Physician_areacode.value="";
			document.feedback.Refering_Physician_areacode.focus();
			return false;
			}
		}
	}	
	
	if(document.feedback.Refering_Physician_phone.value=="")
	{
	alert("Please enter Refering Physician telephone no");
	document.feedback.Refering_Physician_phone.focus();
	return false;
	}
	
	if(document.feedback.phone.value!="")
	{
	var inputstr=document.feedback.Refering_Physician_phone.value.toString();
	for(i=0; i < inputstr.length; i++)
		{
			var ch=inputstr.charAt(i);
			if(ch < "0" || ch > "9") {
			alert("numbers only in Refering Physician ");
			document.feedback.Refering_Physician_phone.value="";
			document.feedback.Refering_Physician_phone.focus();
			return false;
			}
		}
	}
	/* patient telephone detail end */	
	
  if(document.feedback.comments.value=="")
	{
		alert("Please enter your message");
		document.feedback.comments.value="";
		document.feedback.comments.focus();
		return false;
	}
	/* patients detail end */
 
	if(document.feedback.selectque.value==0)
		{
			alert("please select Security Question");
			document.feedback.selectque.focus();
			return false;	
		}
	
	if(document.feedback.txtsecuriry.value=="")
		{
			alert("please enter proper answer");
			document.feedback.txtsecuriry.focus();
			return false;	
		}
	if(document.feedback.txtsecuriry.value!="")
		{
		if(document.feedback.selectque.value==1 && document.feedback.txtsecuriry.value!=10)
				{	
				alert("Enter correct answer");
				document.feedback.txtsecuriry.value="";
				document.feedback.txtsecuriry.focus();
				return false;	
				}
		if (document.feedback.selectque.value==2 && document.feedback.txtsecuriry.value!=8)
				{	
				alert("Enter correct answer");
				document.feedback.txtsecuriry.value="";
				document.feedback.txtsecuriry.focus();
				return false;	
				}
	   if (document.feedback.selectque.value==3 && document.feedback.txtsecuriry.value!=16)
			{	
				alert("Enter correct answer");
				document.feedback.txtsecuriry.value="";
				document.feedback.txtsecuriry.focus();
				return false;	
			}

		}	
	
}	

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;
   	    }	
  }