Free Cataract Surgery Camp - Registration<\/title>\r\n\r\n <style>\r\n * {\r\n box-sizing: border-box;\r\n margin: 0;\r\n padding: 0;\r\n }\r\n\r\n body {\r\n font-family: Arial, Helvetica, sans-serif;\r\n background: linear-gradient(135deg, #eef6ff, #ffffff);\r\n color: #102d55;\r\n min-height: 100vh;\r\n padding: 25px 15px;\r\n }\r\n\r\n .container {\r\n max-width: 850px;\r\n margin: auto;\r\n background: #fff;\r\n border-radius: 18px;\r\n overflow: hidden;\r\n box-shadow: 0 8px 35px rgba(0, 0, 0, 0.15);\r\n }\r\n\r\n \/* Header *\/\r\n .header {\r\n text-align: center;\r\n background: #ffffff;\r\n }\r\n\r\n .free-banner {\r\n background: linear-gradient(90deg, #ff3030, #ff4545);\r\n color: white;\r\n font-size: 42px;\r\n font-weight: 800;\r\n padding: 10px;\r\n letter-spacing: 2px;\r\n }\r\n\r\n .header h1 {\r\n font-size: 52px;\r\n color: #102d55;\r\n margin: 15px 10px 0;\r\n line-height: 1;\r\n }\r\n\r\n .header h2 {\r\n font-size: 30px;\r\n color: #398bd9;\r\n margin: 8px 10px 20px;\r\n letter-spacing: 1px;\r\n }\r\n\r\n \/* Camp details *\/\r\n .camp-info {\r\n background: #102d55;\r\n color: white;\r\n display: grid;\r\n grid-template-columns: repeat(3, 1fr);\r\n gap: 10px;\r\n padding: 20px;\r\n text-align: center;\r\n }\r\n\r\n .info-box {\r\n padding: 10px;\r\n }\r\n\r\n .info-title {\r\n font-size: 13px;\r\n color: #65aef0;\r\n text-transform: uppercase;\r\n font-weight: bold;\r\n margin-bottom: 5px;\r\n }\r\n\r\n .info-value {\r\n font-size: 17px;\r\n font-weight: bold;\r\n }\r\n\r\n \/* Form *\/\r\n .form-section {\r\n padding: 30px 35px 35px;\r\n }\r\n\r\n .form-section h3 {\r\n text-align: center;\r\n font-size: 28px;\r\n color: #102d55;\r\n margin-bottom: 8px;\r\n }\r\n\r\n .subtitle {\r\n text-align: center;\r\n color: #666;\r\n margin-bottom: 25px;\r\n font-size: 14px;\r\n }\r\n\r\n .form-row {\r\n display: grid;\r\n grid-template-columns: 1fr 1fr;\r\n gap: 18px;\r\n }\r\n\r\n .form-group {\r\n margin-bottom: 18px;\r\n }\r\n\r\n label {\r\n display: block;\r\n font-weight: bold;\r\n color: #18375f;\r\n margin-bottom: 7px;\r\n font-size: 14px;\r\n }\r\n\r\n label span {\r\n color: #e33;\r\n }\r\n\r\n input,\r\n select,\r\n textarea {\r\n width: 100%;\r\n padding: 13px 14px;\r\n border: 1px solid #cbd7e5;\r\n border-radius: 8px;\r\n font-size: 15px;\r\n outline: none;\r\n transition: 0.2s;\r\n background: #fafcff;\r\n }\r\n\r\n input:focus,\r\n select:focus,\r\n textarea:focus {\r\n border-color: #398bd9;\r\n box-shadow: 0 0 0 3px rgba(57, 139, 217, 0.12);\r\n background: white;\r\n }\r\n\r\n textarea {\r\n min-height: 85px;\r\n resize: vertical;\r\n }\r\n\r\n .free-services {\r\n background: #f4f9ff;\r\n border: 1px solid #cfe4f7;\r\n border-radius: 10px;\r\n padding: 18px;\r\n margin: 8px 0 22px;\r\n }\r\n\r\n .free-services h4 {\r\n color: #e32d35;\r\n font-size: 18px;\r\n margin-bottom: 10px;\r\n }\r\n\r\n .free-services ul {\r\n padding-left: 20px;\r\n color: #38536e;\r\n line-height: 1.7;\r\n font-size: 14px;\r\n }\r\n\r\n .consent {\r\n display: flex;\r\n align-items: flex-start;\r\n gap: 10px;\r\n margin: 15px 0 20px;\r\n font-size: 13px;\r\n color: #555;\r\n }\r\n\r\n .consent input {\r\n width: auto;\r\n margin-top: 3px;\r\n }\r\n\r\n .register-btn {\r\n width: 100%;\r\n border: none;\r\n background: linear-gradient(90deg, #1db954, #0fa347);\r\n color: white;\r\n padding: 16px;\r\n border-radius: 9px;\r\n font-size: 20px;\r\n font-weight: bold;\r\n cursor: pointer;\r\n transition: 0.2s;\r\n box-shadow: 0 5px 12px rgba(0, 150, 70, 0.2);\r\n }\r\n\r\n .register-btn:hover {\r\n transform: translateY(-1px);\r\n box-shadow: 0 7px 16px rgba(0, 150, 70, 0.3);\r\n }\r\n\r\n .whatsapp-note {\r\n text-align: center;\r\n margin-top: 12px;\r\n font-size: 13px;\r\n color: #666;\r\n }\r\n\r\n .whatsapp-number {\r\n font-weight: bold;\r\n color: #168b42;\r\n }\r\n\r\n \/* Footer *\/\r\n .footer {\r\n background: #102d55;\r\n color: white;\r\n padding: 18px;\r\n text-align: center;\r\n font-size: 13px;\r\n }\r\n\r\n .footer strong {\r\n color: #65aef0;\r\n }\r\n\r\n \/* Mobile *\/\r\n @media (max-width: 650px) {\r\n\r\n body {\r\n padding: 10px;\r\n }\r\n\r\n .free-banner {\r\n font-size: 30px;\r\n }\r\n\r\n .header h1 {\r\n font-size: 36px;\r\n }\r\n\r\n .header h2 {\r\n font-size: 22px;\r\n }\r\n\r\n .camp-info {\r\n grid-template-columns: 1fr;\r\n padding: 12px;\r\n }\r\n\r\n .form-section {\r\n padding: 25px 18px;\r\n }\r\n\r\n .form-row {\r\n grid-template-columns: 1fr;\r\n gap: 0;\r\n }\r\n\r\n .form-section h3 {\r\n font-size: 24px;\r\n }\r\n }\r\n <\/style>\r\n<\/head>\r\n\r\n<body>\r\n\r\n <div class=\"container\">\r\n\r\n \r\n <div class=\"header\">\r\n\r\n <div class=\"free-banner\">\r\n FREE\r\n <\/div>\r\n\r\n <h1>CATARACT<\/h1>\r\n <h2>SURGERY CAMP<\/h2>\r\n\r\n <\/div>\r\n\r\n \r\n <div class=\"camp-info\">\r\n\r\n <div class=\"info-box\">\r\n <div class=\"info-title\">Date<\/div>\r\n <div class=\"info-value\">5th September 2026<\/div>\r\n <\/div>\r\n\r\n <div class=\"info-box\">\r\n <div class=\"info-title\">Time<\/div>\r\n <div class=\"info-value\">10:00 AM \u2013 2:00 PM<\/div>\r\n <\/div>\r\n\r\n <div class=\"info-box\">\r\n <div class=\"info-title\">Location<\/div>\r\n <div class=\"info-value\">Shree Polyclinic & Lab, HSR Branch<\/div>\r\n <\/div>\r\n\r\n <\/div>\r\n\r\n\r\n \r\n <div class=\"form-section\">\r\n\r\n <h3>Register for Cataract Surgery Camp<\/h3>\r\n\r\n <p class=\"subtitle\">\r\n Please fill in your details. Your registration will be sent to us on WhatsApp.\r\n <\/p>\r\n\r\n\r\n <form id=\"registrationForm\">\r\n\r\n <div class=\"form-row\">\r\n\r\n <div class=\"form-group\">\r\n <label for=\"name\">\r\n Patient Name <span>*<\/span>\r\n <\/label>\r\n\r\n <input\r\n type=\"text\"\r\n id=\"name\"\r\n name=\"name\"\r\n placeholder=\"Enter patient name\"\r\n required\r\n >\r\n <\/div>\r\n\r\n\r\n <div class=\"form-group\">\r\n <label for=\"age\">\r\n Age <span>*<\/span>\r\n <\/label>\r\n\r\n <input\r\n type=\"number\"\r\n id=\"age\"\r\n name=\"age\"\r\n placeholder=\"Enter age\"\r\n min=\"1\"\r\n max=\"120\"\r\n required\r\n >\r\n <\/div>\r\n\r\n <\/div>\r\n\r\n\r\n <div class=\"form-row\">\r\n\r\n <div class=\"form-group\">\r\n <label for=\"gender\">\r\n Gender <span>*<\/span>\r\n <\/label>\r\n\r\n <select id=\"gender\" name=\"gender\" required>\r\n <option value=\"\">Select gender<\/option>\r\n <option value=\"Male\">Male<\/option>\r\n <option value=\"Female\">Female<\/option>\r\n <option value=\"Other\">Other<\/option>\r\n <\/select>\r\n <\/div>\r\n\r\n\r\n <div class=\"form-group\">\r\n <label for=\"phone\">\r\n Patient Mobile Number <span>*<\/span>\r\n <\/label>\r\n\r\n <input\r\n type=\"tel\"\r\n id=\"phone\"\r\n name=\"phone\"\r\n placeholder=\"Enter 10-digit mobile number\"\r\n pattern=\"[0-9]{10}\"\r\n maxlength=\"10\"\r\n required\r\n >\r\n <\/div>\r\n\r\n <\/div>\r\n\r\n\r\n <div class=\"form-row\">\r\n\r\n <div class=\"form-group\">\r\n <label for=\"eye\">\r\n Cataract \/ Eye\r\n <\/label>\r\n\r\n <select id=\"eye\" name=\"eye\">\r\n <option value=\"\">Select if known<\/option>\r\n <option value=\"Right Eye\">Right Eye<\/option>\r\n <option value=\"Left Eye\">Left Eye<\/option>\r\n <option value=\"Both Eyes\">Both Eyes<\/option>\r\n <option value=\"Not Sure\">Not Sure<\/option>\r\n <\/select>\r\n <\/div>\r\n\r\n\r\n <div class=\"form-group\">\r\n <label for=\"city\">\r\n Area \/ City\r\n <\/label>\r\n\r\n <input\r\n type=\"text\"\r\n id=\"city\"\r\n name=\"city\"\r\n placeholder=\"Enter your area\/city\"\r\n >\r\n <\/div>\r\n\r\n <\/div>\r\n\r\n\r\n <div class=\"form-group\">\r\n\r\n <label for=\"address\">\r\n Address\r\n <\/label>\r\n\r\n <textarea\r\n id=\"address\"\r\n name=\"address\"\r\n placeholder=\"Enter your address\"\r\n ><\/textarea>\r\n\r\n <\/div>\r\n\r\n\r\n \r\n <div class=\"free-services\">\r\n\r\n <h4>FREE Services for Eligible Patients<\/h4>\r\n\r\n <ul>\r\n <li>Cataract Surgery for eligible patients<\/li>\r\n <li>Eye Drop & Surgery-related Oral Medications<\/li>\r\n <li>Spectacles after 6-week follow-up<\/li>\r\n <li>Consultation with an Ophthalmologist<\/li>\r\n <\/ul>\r\n\r\n <\/div>\r\n\r\n\r\n \r\n <div class=\"consent\">\r\n\r\n <input\r\n type=\"checkbox\"\r\n id=\"consent\"\r\n required\r\n >\r\n\r\n <label for=\"consent\">\r\n I confirm that the information provided is correct and\r\n I agree to be contacted regarding the cataract surgery camp.\r\n <\/label>\r\n\r\n <\/div>\r\n\r\n\r\n \r\n <button\r\n type=\"submit\"\r\n class=\"register-btn\"\r\n >\r\n \ud83d\udcf2 REGISTER NOW ON WHATSAPP\r\n <\/button>\r\n\r\n <p class=\"whatsapp-note\">\r\n Registration will be sent to WhatsApp:\r\n <span class=\"whatsapp-number\">+91 8550001600<\/span>\r\n <\/p>\r\n\r\n <\/form>\r\n\r\n <\/div>\r\n\r\n\r\n \r\n <div class=\"footer\">\r\n\r\n <strong>SHREE POLYCLINIC & LAB<\/strong>\r\n <br>\r\n HSR Branch\r\n <br><br>\r\n\r\n In Association with\r\n <strong>SHRADDHA EYE CARE TRUST<\/strong>\r\n\r\n <\/div>\r\n\r\n <\/div>\r\n\r\n\r\n \r\n <script>\r\n\r\n document\r\n .getElementById(\"registrationForm\")\r\n .addEventListener(\"submit\", function(event) {\r\n\r\n event.preventDefault();\r\n\r\n const name =\r\n document.getElementById(\"name\").value.trim();\r\n\r\n const age =\r\n document.getElementById(\"age\").value.trim();\r\n\r\n const gender =\r\n document.getElementById(\"gender\").value;\r\n\r\n const phone =\r\n document.getElementById(\"phone\").value.trim();\r\n\r\n const eye =\r\n document.getElementById(\"eye\").value || \"Not specified\";\r\n\r\n const city =\r\n document.getElementById(\"city\").value.trim() || \"Not specified\";\r\n\r\n const address =\r\n document.getElementById(\"address\").value.trim() || \"Not specified\";\r\n\r\n\r\n \/*\r\n WhatsApp number:\r\n 91 = India country code\r\n 8550001600 = registration WhatsApp number\r\n *\/\r\n\r\n const whatsappNumber = \"918550001600\";\r\n\r\n\r\n const message =\r\n`*FREE CATARACT SURGERY CAMP \u2013 REGISTRATION*\r\n\r\nHello, I would like to register for the Cataract Surgery Camp.\r\n\r\n*Patient Details*\r\n\r\nPatient Name: ${name}\r\nAge: ${age}\r\nGender: ${gender}\r\nMobile Number: ${phone}\r\nCataract \/ Eye: ${eye}\r\nArea \/ City: ${city}\r\nAddress: ${address}\r\n\r\n*Camp Details*\r\nDate: 5th September 2026\r\nTime: 10:00 AM \u2013 2:00 PM\r\nLocation: Shree Polyclinic & Lab, HSR Branch\r\n\r\nPlease confirm my registration.\r\n\r\nThank you.`;\r\n\r\n\r\n const whatsappURL =\r\n \"https:\/\/wa.me\/\" +\r\n whatsappNumber +\r\n \"?text=\" +\r\n encodeURIComponent(message);\r\n\r\n\r\n window.open(whatsappURL, \"_blank\");\r\n\r\n });\r\n\r\n <\/script>\r\n\r\n<\/body>\r\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Free Cataract Surgery Camp – Registration FREE CATARACT SURGERY CAMP Date 5th September 2026 Time 10:00 AM \u2013 2:00 PM Location Shree Polyclinic & Lab, HSR Branch Register for Cataract Surgery Camp Please fill in your details. Your registration will be sent to us on WhatsApp. Patient Name * Age * Gender * Select genderMaleFemaleOther […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"site-sidebar-layout":"no-sidebar","site-content-layout":"page-builder","ast-site-content-layout":"full-width-container","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"class_list":["post-3284","page","type-page","status-publish","hentry"],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t<meta name=\"description\" content=\"Free Cataract Surgery Camp - Registration FREE CATARACT SURGERY CAMP Date 5th September 2026 Time 10:00 AM \u2013 2:00 PM Location Shree Polyclinic & Lab, HSR Branch Register for Cataract Surgery Camp Please fill in your details. 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color: #398bd9;\r\n margin: 8px 10px 20px;\r\n letter-spacing: 1px;\r\n }\r\n\r\n \/* Camp details *\/\r\n .camp-info {\r\n background: #102d55;\r\n color: white;\r\n display: grid;\r\n grid-template-columns: repeat(3, 1fr);\r\n gap: 10px;\r\n padding: 20px;\r\n text-align: center;\r\n }\r\n\r\n .info-box {\r\n padding: 10px;\r\n }\r\n\r\n .info-title {\r\n font-size: 13px;\r\n color: #65aef0;\r\n text-transform: uppercase;\r\n font-weight: bold;\r\n margin-bottom: 5px;\r\n }\r\n\r\n .info-value {\r\n font-size: 17px;\r\n font-weight: bold;\r\n }\r\n\r\n \/* Form *\/\r\n .form-section {\r\n padding: 30px 35px 35px;\r\n }\r\n\r\n .form-section h3 {\r\n text-align: center;\r\n font-size: 28px;\r\n color: #102d55;\r\n margin-bottom: 8px;\r\n }\r\n\r\n .subtitle {\r\n text-align: center;\r\n color: #666;\r\n margin-bottom: 25px;\r\n font-size: 14px;\r\n }\r\n\r\n .form-row {\r\n display: grid;\r\n grid-template-columns: 1fr 1fr;\r\n gap: 18px;\r\n }\r\n\r\n .form-group {\r\n margin-bottom: 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1.7;\r\n font-size: 14px;\r\n }\r\n\r\n .consent {\r\n display: flex;\r\n align-items: flex-start;\r\n gap: 10px;\r\n margin: 15px 0 20px;\r\n font-size: 13px;\r\n color: #555;\r\n }\r\n\r\n .consent input {\r\n width: auto;\r\n margin-top: 3px;\r\n }\r\n\r\n .register-btn {\r\n width: 100%;\r\n border: none;\r\n background: linear-gradient(90deg, #1db954, #0fa347);\r\n color: white;\r\n padding: 16px;\r\n border-radius: 9px;\r\n font-size: 20px;\r\n font-weight: bold;\r\n cursor: pointer;\r\n transition: 0.2s;\r\n box-shadow: 0 5px 12px rgba(0, 150, 70, 0.2);\r\n }\r\n\r\n .register-btn:hover {\r\n transform: translateY(-1px);\r\n box-shadow: 0 7px 16px rgba(0, 150, 70, 0.3);\r\n }\r\n\r\n .whatsapp-note {\r\n text-align: center;\r\n margin-top: 12px;\r\n font-size: 13px;\r\n color: #666;\r\n }\r\n\r\n .whatsapp-number {\r\n font-weight: bold;\r\n color: #168b42;\r\n }\r\n\r\n \/* Footer *\/\r\n .footer {\r\n background: #102d55;\r\n color: white;\r\n padding: 18px;\r\n text-align: center;\r\n font-size: 13px;\r\n }\r\n\r\n .footer strong {\r\n color: #65aef0;\r\n }\r\n\r\n \/* Mobile *\/\r\n @media (max-width: 650px) {\r\n\r\n body {\r\n padding: 10px;\r\n }\r\n\r\n .free-banner {\r\n font-size: 30px;\r\n }\r\n\r\n .header h1 {\r\n font-size: 36px;\r\n }\r\n\r\n .header h2 {\r\n font-size: 22px;\r\n }\r\n\r\n .camp-info {\r\n grid-template-columns: 1fr;\r\n padding: 12px;\r\n }\r\n\r\n .form-section {\r\n padding: 25px 18px;\r\n }\r\n\r\n .form-row {\r\n grid-template-columns: 1fr;\r\n gap: 0;\r\n }\r\n\r\n .form-section h3 {\r\n font-size: 24px;\r\n }\r\n }\r\n <\/style>\r\n<\/head>\r\n\r\n<body>\r\n\r\n <div class=\"container\">\r\n\r\n \r\n <div class=\"header\">\r\n\r\n <div class=\"free-banner\">\r\n FREE\r\n <\/div>\r\n\r\n <h1>CATARACT<\/h1>\r\n <h2>SURGERY CAMP<\/h2>\r\n\r\n <\/div>\r\n\r\n \r\n <div class=\"camp-info\">\r\n\r\n <div class=\"info-box\">\r\n <div class=\"info-title\">Date<\/div>\r\n <div class=\"info-value\">5th September 2026<\/div>\r\n <\/div>\r\n\r\n <div class=\"info-box\">\r\n <div class=\"info-title\">Time<\/div>\r\n <div class=\"info-value\">10:00 AM \u2013 2:00 PM<\/div>\r\n <\/div>\r\n\r\n <div class=\"info-box\">\r\n <div class=\"info-title\">Location<\/div>\r\n <div class=\"info-value\">Shree Polyclinic & Lab, HSR Branch<\/div>\r\n <\/div>\r\n\r\n <\/div>\r\n\r\n\r\n \r\n <div class=\"form-section\">\r\n\r\n <h3>Register for Cataract Surgery Camp<\/h3>\r\n\r\n <p class=\"subtitle\">\r\n Please fill in your details. Your registration will be sent to us on WhatsApp.\r\n <\/p>\r\n\r\n\r\n <form id=\"registrationForm\">\r\n\r\n <div class=\"form-row\">\r\n\r\n <div class=\"form-group\">\r\n <label for=\"name\">\r\n Patient Name <span>*<\/span>\r\n <\/label>\r\n\r\n <input\r\n type=\"text\"\r\n id=\"name\"\r\n name=\"name\"\r\n placeholder=\"Enter patient name\"\r\n required\r\n >\r\n <\/div>\r\n\r\n\r\n <div class=\"form-group\">\r\n <label for=\"age\">\r\n Age <span>*<\/span>\r\n <\/label>\r\n\r\n <input\r\n type=\"number\"\r\n id=\"age\"\r\n name=\"age\"\r\n placeholder=\"Enter age\"\r\n min=\"1\"\r\n max=\"120\"\r\n required\r\n >\r\n <\/div>\r\n\r\n <\/div>\r\n\r\n\r\n <div class=\"form-row\">\r\n\r\n <div class=\"form-group\">\r\n <label for=\"gender\">\r\n Gender <span>*<\/span>\r\n <\/label>\r\n\r\n <select id=\"gender\" name=\"gender\" required>\r\n <option value=\"\">Select gender<\/option>\r\n <option value=\"Male\">Male<\/option>\r\n <option value=\"Female\">Female<\/option>\r\n <option value=\"Other\">Other<\/option>\r\n <\/select>\r\n <\/div>\r\n\r\n\r\n <div class=\"form-group\">\r\n <label for=\"phone\">\r\n Patient Mobile Number <span>*<\/span>\r\n <\/label>\r\n\r\n <input\r\n type=\"tel\"\r\n id=\"phone\"\r\n name=\"phone\"\r\n placeholder=\"Enter 10-digit mobile number\"\r\n pattern=\"[0-9]{10}\"\r\n maxlength=\"10\"\r\n required\r\n >\r\n <\/div>\r\n\r\n <\/div>\r\n\r\n\r\n <div class=\"form-row\">\r\n\r\n <div class=\"form-group\">\r\n <label for=\"eye\">\r\n Cataract \/ Eye\r\n <\/label>\r\n\r\n <select id=\"eye\" name=\"eye\">\r\n <option value=\"\">Select if known<\/option>\r\n <option value=\"Right Eye\">Right Eye<\/option>\r\n <option value=\"Left Eye\">Left Eye<\/option>\r\n <option value=\"Both Eyes\">Both Eyes<\/option>\r\n <option value=\"Not Sure\">Not Sure<\/option>\r\n <\/select>\r\n <\/div>\r\n\r\n\r\n <div class=\"form-group\">\r\n <label for=\"city\">\r\n Area \/ City\r\n <\/label>\r\n\r\n <input\r\n type=\"text\"\r\n id=\"city\"\r\n name=\"city\"\r\n placeholder=\"Enter your area\/city\"\r\n >\r\n <\/div>\r\n\r\n <\/div>\r\n\r\n\r\n <div class=\"form-group\">\r\n\r\n <label for=\"address\">\r\n Address\r\n <\/label>\r\n\r\n <textarea\r\n id=\"address\"\r\n name=\"address\"\r\n placeholder=\"Enter your address\"\r\n ><\/textarea>\r\n\r\n <\/div>\r\n\r\n\r\n \r\n <div class=\"free-services\">\r\n\r\n <h4>FREE Services for Eligible Patients<\/h4>\r\n\r\n <ul>\r\n <li>Cataract Surgery for eligible patients<\/li>\r\n <li>Eye Drop & Surgery-related Oral Medications<\/li>\r\n <li>Spectacles after 6-week follow-up<\/li>\r\n <li>Consultation with an Ophthalmologist<\/li>\r\n <\/ul>\r\n\r\n <\/div>\r\n\r\n\r\n \r\n <div class=\"consent\">\r\n\r\n <input\r\n type=\"checkbox\"\r\n id=\"consent\"\r\n required\r\n >\r\n\r\n <label for=\"consent\">\r\n I confirm that the information provided is correct and\r\n I agree to be contacted regarding the cataract surgery camp.\r\n <\/label>\r\n\r\n <\/div>\r\n\r\n\r\n \r\n <button\r\n type=\"submit\"\r\n class=\"register-btn\"\r\n >\r\n \ud83d\udcf2 REGISTER NOW ON WHATSAPP\r\n <\/button>\r\n\r\n <p class=\"whatsapp-note\">\r\n Registration will be sent to WhatsApp:\r\n <span class=\"whatsapp-number\">+91 8550001600<\/span>\r\n <\/p>\r\n\r\n <\/form>\r\n\r\n <\/div>\r\n\r\n\r\n \r\n <div class=\"footer\">\r\n\r\n <strong>SHREE POLYCLINIC & LAB<\/strong>\r\n <br>\r\n HSR Branch\r\n <br><br>\r\n\r\n In Association with\r\n <strong>SHRADDHA EYE CARE TRUST<\/strong>\r\n\r\n <\/div>\r\n\r\n <\/div>\r\n\r\n\r\n \r\n <script>\r\n\r\n document\r\n .getElementById(\"registrationForm\")\r\n .addEventListener(\"submit\", function(event) {\r\n\r\n event.preventDefault();\r\n\r\n const name =\r\n document.getElementById(\"name\").value.trim();\r\n\r\n const age =\r\n document.getElementById(\"age\").value.trim();\r\n\r\n const gender =\r\n document.getElementById(\"gender\").value;\r\n\r\n const phone =\r\n document.getElementById(\"phone\").value.trim();\r\n\r\n const eye =\r\n document.getElementById(\"eye\").value || \"Not specified\";\r\n\r\n const city =\r\n document.getElementById(\"city\").value.trim() || \"Not specified\";\r\n\r\n const address =\r\n document.getElementById(\"address\").value.trim() || \"Not specified\";\r\n\r\n\r\n \/*\r\n WhatsApp number:\r\n 91 = India country code\r\n 8550001600 = registration WhatsApp number\r\n *\/\r\n\r\n const whatsappNumber = \"918550001600\";\r\n\r\n\r\n const message =\r\n`*FREE CATARACT SURGERY CAMP \u2013 REGISTRATION*\r\n\r\nHello, I would like to register for the Cataract Surgery Camp.\r\n\r\n*Patient Details*\r\n\r\nPatient Name: ${name}\r\nAge: ${age}\r\nGender: ${gender}\r\nMobile Number: ${phone}\r\nCataract \/ Eye: ${eye}\r\nArea \/ City: ${city}\r\nAddress: ${address}\r\n\r\n*Camp Details*\r\nDate: 5th September 2026\r\nTime: 10:00 AM \u2013 2:00 PM\r\nLocation: Shree Polyclinic & Lab, HSR Branch\r\n\r\nPlease confirm my registration.\r\n\r\nThank you.`;\r\n\r\n\r\n const whatsappURL =\r\n 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Your registration will be sent to us on WhatsApp. Patient Name * Age * Gender * Select genderMaleFemaleOther […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"site-sidebar-layout":"no-sidebar","site-content-layout":"page-builder","ast-site-content-layout":"full-width-container","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"class_list":["post-3284","page","type-page","status-publish","hentry"],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t<meta name=\"description\" content=\"Free Cataract Surgery Camp - Registration FREE CATARACT SURGERY CAMP Date 5th September 2026 Time 10:00 AM \u2013 2:00 PM Location Shree Polyclinic & Lab, HSR Branch Register for Cataract Surgery Camp Please fill in your details. 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