Feedback Entry<form action="http://sdm.sandbox.jalanidhi.in/api/index/" method="POST">
Scheme ID: <input type="text" name="scheme_id"><br>
1. Water quality(taste/smell/color)<br>
<input type="radio" value="1" name="q1option">Very dissatisfied
<input type="radio" value="2" name="q1option">Dissatisfied
<input type="radio" value="3" name="q1option">Neither satisfied nor dissatisfied
<input type="radio" value="4" name="q1option">Satisfied
<input type="radio" value="5" name="q1option">Very Satisfied
<input type="radio" value="6" name="q1option">Not applicable
<br>
2. Duration of water supply<br>
<input type="radio" value="1" name="q2option">Very dissatisfied
<input type="radio" value="2" name="q2option">Dissatisfied
<input type="radio" value="3" name="q2option">Neither satisfied nor dissatisfied
<input type="radio" value="4" name="q2option">Satisfied
<input type="radio" value="5" name="q2option">Very Satisfied
<input type="radio" value="6" name="q2option">Not applicable
<br>
3. Water pressure<br>
<input type="radio" value="1" name="q3option">Very dissatisfied
<input type="radio" value="2" name="q3option">Dissatisfied
<input type="radio" value="3" name="q3option">Neither satisfied nor dissatisfied
<input type="radio" value="4" name="q3option">Satisfied
<input type="radio" value="5" name="q3option">Very Satisfied
<input type="radio" value="6" name="q3option">Not applicable
<br>
4. Regularity of water supply<br>
<input type="radio" value="1" name="q4option">Very dissatisfied
<input type="radio" value="2" name="q4option">Dissatisfied
<input type="radio" value="3" name="q4option">Neither satisfied nor dissatisfied
<input type="radio" value="4" name="q4option">Satisfied
<input type="radio" value="5" name="q4option">Very Satisfied
<input type="radio" value="6" name="q4option">Not applicable
<br>
5. Satisfaction with the adequacy of water supplied during last summer<br>
<input type="radio" value="1" name="q5option">Very dissatisfied
<input type="radio" value="2" name="q5option">Dissatisfied
<input type="radio" value="3" name="q5option">Neither satisfied nor dissatisfied
<input type="radio" value="4" name="q5option">Satisfied
<input type="radio" value="5" name="q5option">Very Satisfied
<input type="radio" value="6" name="q5option">Not applicable
<br>
6.Overall satisfaction level<br>
<input type="radio" value="1" name="q6option">Very dissatisfied
<input type="radio" value="2" name="q6option">Dissatisfied
<input type="radio" value="3" name="q6option">Neither satisfied nor dissatisfied
<input type="radio" value="4" name="q6option">Satisfied
<input type="radio" value="5" name="q6option">Very Satisfied
<input type="radio" value="6" name="q6option">Not applicable
<br>
<!-- Mobile: <input type="text" name="mobile"><br>
IMEI No: <input type="text" name="imei"><br> -->
Service: <input type="text" value="feedbackEntry" readonly name="service"><br>
API Key: <input type="text" value="sdmapikey" readonly name="API_KEY"><br>
<input type="submit">
</form>
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