<?php include("header.php"); ?>
<div class="greyBg"> 
    <div class="container">
		<div class="wrapper">
			<div class="row">
				<div class="col-sm-12">
					<div class="breadcrumbs">
				        <ul>
				          	<li><a href="#">Home</a></li>
				         	<li><span class="dot">/</span><a href="#">Contact Us</a></li>
				        </ul>
	                </div>
                </div>
		    </div>
		    <div class="row">
		    	<div class="col-sm-12">
		    		<h1 class="text-center hidden-xs">We’d Love to Hear from You.</h1>
		    		<div class="contact">
		    			<div class="formText"><h5 class="text-center">Please fill out the below form (it only takes a few minutes) and we’d get back to you shortly. Or send us an email at <a href="mailto:care@addveda.com"><u>care@addveda.com</u></a> <br>or<br><i class="fa fa-map-marker fa-lg"></i> &nbsp; Dr. Passi Hospital, Ludhiana - 8, India, <i class="fa fa-phone fa-lg left20"></i> &nbsp; M: 9988320528</h5></div>
		    			<div class="row text-center"></div>
		    			<div class="formhr"></div>
		    			<div class="contactForm">
		    				<div class="contactFormDiv">
		    				<label>Name<sup>*</sup></label>
		    				<input type="text" value=""/>
		    			    </div>
		    				<div class="contactFormDiv">
		    					<label>Email<sup>*</sup></label>
		    					<input type="text" value=""/>
		    				</div>
		    				<div class="contactFormDiv last">
		    					<label>Telephone</label>
		    					<input type="text" value=""/>
		    				</div>
		    				<label>Comment<sup>*</sup></label>
		    				<textarea rows="4" cols="50" name="message"></textarea>
		    				<input type="submit" value="Submit here" />
		    			</div>
		    		</div>
		    	</div>
		    </div>
		</div>
	</div>
</div>	
<?php include("footer.php"); ?> 