$meshednew->desc_event_o = mysql_real_escape_string($_REQUEST['event_desc']);
$meshednew->location_event_o = mysql_real_escape_string($_REQUEST['event_location']);
$meshednew->desc_injury_o = mysql_real_escape_string($_REQUEST['injury_desc']);
$meshednew->police_report_o_o = mysql_real_escape_string($_REQUEST['police_reportt']);
$meshednew->other_injured_o = mysql_real_escape_string($_REQUEST['other_injured']);
$meshednew->witness_o = "";
$meshednew->user_email_o = mysql_real_escape_string($_SESSION['email']);
$meshednew->s_m_r_r_f_o = mysql_real_escape_string($_POST['signed_medical']);
$meshednew->other_records_o = mysql_real_escape_string($_POST['other_records']);
$meshednew->travel_bills_o = mysql_real_escape_string($_POST['travel_bills']);
$meshednew->medical_records_o = mysql_real_escape_string($_POST['medical_records']);
$meshednew->medial_bill_o = mysql_real_escape_string($_POST['medical_bill']);
$meshednew->police_report_oo = mysql_real_escape_string($_POST['police_report']);
$meshednew->user_email_o = $_SESSION['email'];
$case_type = "5";
$test = $meshednew->OrthoStep($form_id, $user_id, $att_id, $case_type);
if ($test = 1) {
echo "<div class='thank_message'>Your Form is Submitted Successfully. You will get an email when form is accepted by Admin</div>";
header("Refresh:3; url=index.php");
unset($_SESSION['email']);
} else {
echo "<div class='thank_message'>There is some problem Please retry later</div>";
}
}
?>
<h1>Ortho Step-2 Form</h1>
<form name="ortho" id="ortho" method="post" action="">
<div class="client_1">
<div class="attorney_row">
<h2>Client Information</h2>
</div>