<%@ Page Language="C#" AutoEventWireup="true" CodeBehind="reg_patient.aspx.cs" Inherits="Comfora.reg_patient" %> <%@ Register Assembly="AjaxControlToolkit" Namespace="AjaxControlToolkit" TagPrefix="cc1" %> Untitled Page <%-- --%>
Comfora
<%--
--%>
Registration

Registration

Personal Details
First Name: *
Last Name:
Gender: * <%-- Male Female--%> <%----%>
Email address: * <%-- --%>
Telephone: * <%-- --%>
Mobile: <%-- --%>

Contact Details
Address 1: * <%-- --%>
Address 2: <%-- --%>
Suburb/Town: <%-- --%>
City: * <%-- --%>
Postcode: * <%-- --%>
State: * <%-- --%>
Country: * <%-- --%>

Login Details
Password: * <%-- --%>
Confirm Password: * <%-- --%>