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<!DOCTYPE html>
<html lang="en" >
<head>
<meta charset="UTF-8">
<link rel="apple-touch-icon" type="image/png" href="https://cpwebassets.codepen.io/assets/favicon/apple-touch-icon-5ae1a0698dcc2402e9712f7d01ed509a57814f994c660df9f7a952f3060705ee.png" />
<meta name="apple-mobile-web-app-title" content="CodePen">
<link rel="shortcut icon" type="image/x-icon" href="https://cpwebassets.codepen.io/assets/favicon/favicon-aec34940fbc1a6e787974dcd360f2c6b63348d4b1f4e06c77743096d55480f33.ico" />
<link rel="mask-icon" type="image/x-icon" href="https://cpwebassets.codepen.io/assets/favicon/logo-pin-b4b4269c16397ad2f0f7a01bcdf513a1994f4c94b8af2f191c09eb0d601762b1.svg" color="#111" />
<title>NeuroTx ECG Data Upload</title>
<link rel="canonical" href="https://codepen.io/getform/pen/mgEazR" />
<link rel='stylesheet' href='https://cdnjs.cloudflare.com/ajax/libs/twitter-bootstrap/4.1.3/css/bootstrap.min.css'>
<style>
h1 {
font-size: 20px;
margin-top: 24px;
margin-bottom: 24px;
}
img {
height: 60px;
}
</style>
<script>
window.console = window.console || function(t) {};
</script>
</head>
<body translate="no">
<div class="col-md-6 offset-md-3 mt-5">
<h1>NeuroTx ECG Data Upload</h1>
<form accept-charset="UTF-8" action="https://asia-northeast3-neurotx-355406.cloudfunctions.net/ecg_data_upload" method="POST" enctype="multipart/form-data" target="_blank">
<div class="form-group">
<label for="exampleInputName">환자 이름</label>
<input type="text" name="name" class="form-control" id="name" placeholder="환자 이름을 적어주세요." required="required">
</div>
<div class="form-group">
<label for="exampleInputEmail1" required="required">실험 일시</label>
<input type="text" name="exp_time" class="form-control" id="exp_time" placeholder="YYYY-MM-DD HH:MM:SS">
</div>
<hr>
<div class="form-group mt-3">
<label class="mr-2">실험 데이터 파일 업로드</label>
<input type="file" name="file" multiple>
</div>
<hr>
<button type="submit" class="btn btn-primary">Submit</button>
</form>
</div>
</body>
</html>