Image-Viewer/uploader.html at master · Lincolnnus/Image-Viewer · GitHub

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<html>
<body>

<form action="api/uploader.php" method="post"
enctype="multipart/form-data">
<label for="pName">Patient Name</label>
<input type="text" name="pName"/><br />
<label for="pAge">Patient Age</label>
<input type="text" name="pAge"/><br />
<label for="modality">Modality</label>
<input type="text" name="modality"/><br />
<label for="maxWid">Image Max Width(pixels)</label>
<input type="text" name="maxWid"/><br />
<label for="maxHei">Image Max Height(pixels)</label>
<input type="text" name="maxHei"/><br />
<label for="ratio">Image Ratio(One pixel equals to ?mm in real case)</label>
<input type="text" name="ratio"/><br />
<label for="file">Filename:</label>
<input type="file" name="file" id="file" />
<br />
<input type="submit" name="submit" value="Submit" />
</form>

</body>
</html>