Kannur Ayurvedic Multispeciality Hospital

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Advance Booking

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Description of illness *	<br> <span id="illnessInfo" style="font:'Times New Roman', Times, serif; font-size:9px;"></span> </th> </tr> <tr> <td align="left" class="text" scope="col">Date of Arrival<span class="star"></span></td> <th align="left" scope="col"> <input name="txt_arrdate" id="txt_arrdate" type="text" class="fieldborder" value="" /> <a href="javascript:NewCal('txt_arrdate','ddmmmyyyy',true,24)"> <img src="images/cal.gif" width="16" height="16" border="0" alt="Pick a date"></a><br> <span id="arrdateInfo" style="font:'Times New Roman', Times, serif; font-size:9px;"></span> </th> </tr> <tr> <td align="left" class="text" scope="col">Arrival Destination<span class="star"></span></td> <th align="left" scope="col"><input name="txt_arrdest" id="txt_arrdest" type="text" class="fieldborder" value="" /> <br> <span id="arrdestInfo" style="font:'Times New Roman', Times, serif; font-size:9px;"></span> </th> </tr> <tr> <td align="left" class="text" scope="col">Date of Departure<span class="star"></span></td> <th align="left" scope="col"><input name="txt_deptdate" id="txt_deptdate" type="text" class="fieldborder" value="" /> <a href="javascript:NewCal('txt_deptdate','ddmmmyyyy',true,'')"> <img src="images/cal.gif" width="16" height="16" border="0" alt="Pick a date"></a> <br> <span id="deptdateInfo" style="font:'Times New Roman', Times, serif; font-size:9px;"></span> </th> </tr> <tr> <td align="left" class="text" scope="col">Departure Destination <span class="star"></span></td> <th align="left" scope="col"><input name="txt_deptdest" id="txt_deptdest" type="text" class="fieldborder" value="" /> <br> <span id="deptdestInfo" style="font:'Times New Roman', Times, serif; font-size:9px;"></span> </th> </tr> <tr> <td align="left" class="text" scope="col">Message</td> <th align="left" scope="col"><textarea name="txt_msg" id="txt_msg" rows="3" class="fieldborder">

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