#!/usr/bin/perl

$imgprefix='../';

if ($ENV{'REQUEST_METHOD'} eq 'POST') {
 read(STDIN,$buffer,$ENV{'CONTENT_LENGTH'});
}
else {
 $buffer=$ENV{'QUERY_STRING'};
}
@pairs=split(/&/,$buffer);

foreach $pair (@pairs) {
 ($name,$value)=split(/=/,$pair);
 $value =~ tr/+/ /;
 $value =~ s/%([a-fA-F0-9][a-fA-F0-9])/pack('C',hex($1))/eg;
 $in{$name}=$value;
 if ($name ne 'q1' && $name ne 'q2' && $name ne 'error') {$hidden .= "<INPUT TYPE=HIDDEN NAME=\"$name\" VALUE=\"$value\">\n";} 
}

open(infile,'treatment-advisor-template.html');
while(<infile>) {
 $page.=$_;
}
close(infile);

$content .= <<"print_tag";
<P>Let the Treatment Advisor help provide you with information which will help you to
decide which is the right treatment for you.</P>
<p>
Simply answer these questions so that your needs can be assessed and receive
information on appropriate treatments*. There are five questions in total.

<p>*When taking a constipation remedy, always read the label. If constipation persists or is particularly troublesome, please consult your doctor.
print_tag

if ($in{'error'} == 1) {$content .= '<P><FONT COLOR="#FF0000"><strong>Please select an answer for all the questions</strong></FONT></P>';}

$content .= <<"print_tag";
<FORM METHOD=POST NAME="form1" ACTION="treatment2.cgi">
$hidden
        <div align="center"><table width="500" border="0" cellspacing="0" cellpadding="0">
          <tr>
            <td bgcolor="#CEEBF7" width=30><img src="$imgprefix/images/spacer.gif" width=30 height=1 alt="" border="0"></td>
            <td bgcolor="#CEEBF7">
            <br>
            <h2 style="margin-bottom: 0px;"><span style="color: #818181;">Q1) Are you (or your child) male or female?</SPAN></h2><span style="color: #818181;">
              <strong><div width=100% style="padding: 5px;">
print_tag

%options=(0,'Male',1,'Female');
foreach $key (sort{$a<=>$b} keys %options) {
 $content .= "<input type=\"radio\" name=\"q1\" value=\"$key\"";
 $content .= ' CHECKED' if $in{'q1'} eq $key;
 $content .= ">$options{$key}<br>\n";
}

$content .= <<"print_tag";
              </div></strong>
            </SPAN></td>
            <td bgcolor="#CEEBF7" width=30><img src="$imgprefix/images/spacer.gif" width=30 height=1 alt="" border="0"></td>
          </tr>
          <tr>
          <td colspan="3" bgcolor="#CEEBF7"><hr size="1" width="100%" color="#808080"></td>
          </tr>
          <tr>
            <td bgcolor="#CEEBF7" width=30><img src="$imgprefix/images/spacer.gif" width=30 height=1 alt="" border="0"></td>
            <td bgcolor="#CEEBF7">
            <br>
            <h2 style="margin-bottom: 0px;"><span style="color: #818181;">Q2) What age are you (or your child)?</SPAN></h2><span style="color: #818181;">
              <strong><div width=100% style="padding: 5px;">
print_tag

%options=(0,'under 6',1,'6-12',2,'13-35',3,'36-54',4,'over 54');
foreach $key (sort{$a<=>$b} keys %options) {
 $content .= "<input type=\"radio\" name=\"q2\" value=\"$key\"";
 $content .= ' CHECKED' if $in{'q2'} eq $key;
 $content .= ">$options{$key}<br>\n";
}

$content .= <<"print_tag";
              </div></strong>
            </SPAN></td>
            <td bgcolor="#CEEBF7" width=30><img src="$imgprefix/images/spacer.gif" width=30 height=1 alt="" border="0"></td>
          </tr>
        </table>
        <table width="500" border="0" cellspacing="0" cellpadding="0" background="$imgprefix/images/box-quiz-blue-bot.gif">
          <tr>
            <td align="CENTER" valign="TOP"><img src="$imgprefix/images/spacer.gif" width=1 height=8 border=0 alt=""><br><a href="javascript:document.form1.submit()" style="color: #FFFFFF;" onMouseOver="this.style.color='#FFE6BC'; self.status='Click her to submit your answer'; this.style.color='#FFFFFF';"><strong>Click here for question 3</strong> <img src="$imgprefix/images/arrows-orange.gif" width=11 height=11 border=0 alt=""></a><br><img src="$imgprefix/images/spacer.gif" width=1 height=8 border=0 alt=""></td>
          </tr>
        </table></div>
</FORM>
print_tag

$page =~ s/\[content\]/$content/;

print<<"print_tag";
Content-Type: text/html

$page
print_tag