Online Feedback Form

\r\n"; $message= "

Sooriya Hospital Enquiry Details

Name	:	".$name."

Ip Number/Op Number	:	".$ipnumber."

Feedback/suggestion	:	".$feedback."

"; if(mail($to,$subject,$message,$headers)) { echo "

Thank You for your feedback!

"; } else { echo "

Something Went Wrong. Please Try Again!

"; } } } ?>

Your Feedback is important to us!