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index.php
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<!DOCTYPE html>
<html lang="es">
<head>
<title>encuestas</title>
<meta name="viewport" content="width=device-width, initial-scale=1.0" />
<meta charset="utf-8" />
<!-- material icons -->
<link
rel="stylesheet"
href="https://fonts.googleapis.com/icon?family=Material+Icons"
/>
<!-- materialize css -->
<link
rel="stylesheet"
type="text/css"
href="https://cdnjs.cloudflare.com/ajax/libs/materialize/1.0.0/css/materialize.min.css"
/>
</head>
<body>
<nav class="nav-wrapper black">
<a href="#" class="brand-logo center">flash mobile</a>
</nav>
<main class="container">
<header class="center">
<h1 class="flow-text">encuesta de usuarios flash mobile</h1>
</header>
<!--encuesta Flash Mobile-->
<section>
<form id="encuesta" class="row">
<div class="card-content">
<div class="input-field col s6">
<label for="caja1">nombre completo</label>
<input
type="text"
id="caja1"
name="name"
required
autocomplete="off"
/>
</div>
<!-- lista deplegable 1-->
<div class="input-field col s6">
<select id="tipo_documento" class="options" name="tipo_documento">
<option value="" selected>¿tipo de documento?</option>
<option value="ti">TI</option>
<option value="cc">CC</option>
<option value="ce">CE</option>
</select>
</div>
<div class="input-field col s6">
<label for="caja2">numero de documento</label>
<input
type="number"
id="caja2"
name="num"
required
autocomplete="off"
/>
</div>
<div class="input-field col s6">
<select id="motivo_llamada" name="motivo_llamada" required>
<option value="" selected>¿motivo de la llamada?</option>
<option value="peticion">Petición</option>
<option value="queja">Queja</option>
<option value="reclamo">Reclamo</option>
</select>
</div>
<div class="input-field col s6">
<select id="nivel" name="nivel">
<option value="" selected required>¿Nivel de satisfacción?</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select>
</div>
<div class="input-field col s6">
<label for="num_llamadas">
¿N° llamadas para el problema?
</label>
<input
type="number"
id="num_llamadas"
name="num_llamadas"
required
autocomplete="off"
/>
</div>
<div class="input-field col s6">
<select id="recomendacion" name="recomendacion">
<option value="" selected>¿Recomendarías este servicio?</option>
<option value="si">SI</option>
<option value="no">NO</option>
</select>
</div>
<div class="input-field col s6">
<label for="comentarios">comentarios</label>
<input
type="text"
id="comentarios"
name="comentarios"
autocomplete="off"
/>
</div>
</div>
<div class="card-action">
<button class="btn" type="submit">enviar encuesta</button>
</div>
</form>
</section>
</main>
<!-- materialize css scripts -->
<script src="https://cdnjs.cloudflare.com/ajax/libs/materialize/1.0.0/js/materialize.min.js"></script>
<!-- main script -->
<script src="js/main.js"></script>
<?php
file_put_contents("php://stderr", "php ajax encuesta\n");
?>
</body>
</html>