PK

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	<h1>Welcome To Urology Solution</h1>
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<div id="contact_form"> <br>
<h6>Contact Form:</h6>
<form method="post" name="contact" id="contact_form">
  <table width="97%">
	<tbody>
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	  <td class="body"  align="left" valign="top" width="145"><strong>Company:</strong></td></label>
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	  <label style="display: none;" class="error" for="company" id="company_error">Company is required.</label></td>
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	<tr>
      <label for="name" id="name_label">
	  <td class="body"  align="left" valign="top"><strong>Full Name:</strong></td></label>
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	  <input name="name"id ="name" size="30" type="text"></td>
	  <td><label style="display: none;" class="error" for="name" id="name_error"><b>Name is required.</b></label></td>
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	  <label for="address" id="address_label">
	  <td class="body"  align="left" valign="top"><strong>Address: </strong></td></label>
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	  <input name="address" id="address" size="30" type="text"></td>
	  <td><label style="display: none;" class="error" for="address" id="adress_error"><b>Address is required.</b></label></td>
	</tr>
	<tr>
	  <label for="phone" id="phone_label">
	  <td class="body" align="left" valign="top"><strong> Phone: </strong></td></label>
	  <td align="left" valign="top">
	<input name="phone" id="phone" size="30" maxlength="10" type="text" onKeyPress="return isNumberKey(event)" ></td>
	  <td><label style="display: none;" class="error" for="phone" id="phone_error"><b>Phone is required.</b></label></td>
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	  <label for="email" id="email_label">
	  <td class="body"  align="left" valign="top"><strong> Email: </strong></td></label>
	  <td align="left" valign="top">
	  <input name="email"id="email" size="30" type="text"></td>
	 <td> <label style="display: none;" class="error" for="email" id="email_error"><b>Email is required.</b></label>
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	  <label for="comments" id="comments_label">
	  <td class="body"  align="left" valign="top"><strong> Questions / Comments: </strong></td></label>
	  <td align="left" valign="top">
	  <textarea name="comments"id="comments" cols="25" rows="6"></textarea></td>
	 <td> <label style="display: none;" class="error" for="comments" id="comments_error"><b>Questions is required.</b></label></td>
	</tr>
	<tr>
	  <td></td>
	  <td><input name="Sub" class="button" value="Send Now" id="sub" type="button"></td>
	</tr>
  </tbody></table>
</form>
</div>
<div> <br>
<h6>Contact Information: </h6>

<img src="images/excellentcare.jpg"alt="" class="project-img" height="100" width="152" />Xcellent Care Hospital</br>
					7th Cross Steet Rajalakshmi Nagar,</br>
					100 Feet Byepass Road,</br>
					Velachery , Chennai</br>
					India , PIN:600042</br>
					<!--TEL : +91 9791014797</br>-->
					Email : <u>drknatarajan@yahoo.co.in</u><br>
<p> <span><img src="images/ico-phone.png" alt="Phone" height="16" hspace="2" width="20"> Phone:</span> +91 9791014797<br>
  <!--<span><img src="images/ico-fax.png" alt="Fax" height="16" hspace="2" width="20"> Fax:</span> (888) 987 654 321<br>-->
  <span><img src="images/ico-website.png" alt="WWW Link" height="16" hspace="2" width="20"> Website:</span> <a href="http://urologysolution.com/">www.urologysolution.com</a><br>
  <span><img src="images/ico-email.png" alt="Email" height="16" hspace="2" width="20"> Email:</span> <a href="mailto:drknatarajan@yahoo.co.in">drknatarajan@yahoo.co.in</a><br>
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</div>
</div>	
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</div>

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PK 99