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To: [email protected], [email protected]
Subject: New submission from 'Medical Consultation Form'!
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Date: Thu, 12 Mar 2020 16:51:41 +0530
From: Eklavya Team <[email protected]>
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This is a multi-part message in MIME format.

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Content-Type: text/plain; charset=us-ascii


You have a new submission from .

Name
Name
{Name:body}

{Name:validation}


Phone
Phone No.
{Phone:body}

{Phone:validation}


Email
Email
{Email:body}

{Email:validation}


Location 
Location 
{Location :body}

{Location :validation}


Urgency
Urgency (lowest to highest) - 1 to 5
{Urgency:body}

{Urgency:validation}


Current Problem
Current Problem
{Current Problem:body}

{Current Problem:validation}


How_Long
How long since the problem started/persisted
{How_Long:body}

{How_Long:validation}


history
Related  medical history, if any
{history:body}

{history:validation}


Submit_Button

{Submit_Button:body}
{Submit_Button:validation}


Case No
{Case No:body}
{Case No:validation}


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Content-Type: text/html; charset=us-ascii

<p>You have a new submission from .</p>
<p><strong>Name</strong></p>
<pre>Name</pre>
<pre>{Name:body}</pre>
<pre></pre>
<pre>{Name:validation}</pre>
<p><br /><strong>Phone</strong></p>
<pre>Phone No.</pre>
<pre>{Phone:body}</pre>
<pre></pre>
<pre>{Phone:validation}</pre>
<p><br /><strong>Email</strong></p>
<pre>Email</pre>
<pre>{Email:body}</pre>
<pre></pre>
<pre>{Email:validation}</pre>
<p><br /><strong>Location </strong></p>
<pre>Location </pre>
<pre>{Location :body}</pre>
<pre></pre>
<pre>{Location :validation}</pre>
<p><br /><strong>Urgency</strong></p>
<pre>Urgency (lowest to highest) - 1 to 5</pre>
<pre>{Urgency:body}</pre>
<pre></pre>
<pre>{Urgency:validation}</pre>
<p><br /><strong>Current Problem</strong></p>
<pre>Current Problem</pre>
<pre>{Current Problem:body}</pre>
<pre></pre>
<pre>{Current Problem:validation}</pre>
<p><br /><strong>How_Long</strong></p>
<pre>How long since the problem started/persisted</pre>
<pre>{How_Long:body}</pre>
<pre></pre>
<pre>{How_Long:validation}</pre>
<p><br /><strong>history</strong></p>
<pre>Related  medical history, if any</pre>
<pre>{history:body}</pre>
<pre></pre>
<pre>{history:validation}</pre>
<p><br /><strong>Submit_Button</strong></p>
<pre></pre>
<pre>{Submit_Button:body}</pre>
<pre>{Submit_Button:validation}</pre>
<p><br /><strong>Case No</strong></p>
<pre>{Case No:body}</pre>
<pre>{Case No:validation}</pre>



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