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Please Fill in the form fields below... Note that all form fields are required fields, Please do not leave any of them blank. <%=strError%> 1)- Account Information City    <% a="" b="" c="" d="" e="" f="" g="" i="" j="" k="" l="" m="" n="" o="" p="" q="" r="" s="" t="" u="" v="" w="" x="" w="" z="" if selected=1 then a="selected" if selected=2 then b="selected" if selected=3 then c="selected" if selected=4 then d="selected" if selected=5 then e="selected" if selected=6 then f="selected" if selected=7 then g="selected" if selected=8 then h="selected" if selected=9 then A2="selected" if selected=10 then j="selected" if selected=11 then k="selected" if selected=12 then l="selected" if selected=13 then m="selected" if selected=14 then A1="selected" if selected=15 then o="selected" if selected=16 then p="selected" if selected=17 then q="selected" if selected=18 then r="selected" if selected=19 then s="selected" if selected=20 then t="selected" if selected=21 then u="selected" if selected=22 then v="selected" if selected=23 then w="selected" if selected=24 then x="selected" if selected=25 then y="selected" %> Select city VALUE="acount.asp?pr=02&selected=1">cairo VALUE="acount.asp?pr=03&selected=2">alexanderia VALUE="acount.asp?pr=088&selected=3">Asyut VALUE="acount.asp?pr=097&selected=4">Aswan VALUE="acount.asp?pr=013&selected=5">Benha VALUE="acount.asp?pr=082&selected=6">Beni suef VALUE="acount.asp?pr=045&selected=7">Damanhur VALUE="acount.asp?pr=057&selected=8">Dumyat VALUE="acount.asp?pr=068&selected=9">El arish VALUE="acount.asp?pr=0843&selected=10">El faiyum VALUE="acount.asp?pr=&selected=11">El Kharga VALUE="acount.asp?pr=050&selected=12">El mansura VALUE="acount.asp?pr=086&selected=13">El Minya VALUE="acount.asp?pr=02&selected=14">Giza VALUE="acount.asp?pr=065&selected=15">Hurgada VALUE="acount.asp?pr=064&selected=16">Ismailia VALUE="acount.asp?pr=0143&selected=17">kafr el sheikh VALUE="acount.asp?pr=0490&selected=18">Matruh VALUE="acount.asp?pr=0220&selected=19">Port said VALUE="acount.asp?pr=0611&selected=20">qena VALUE="acount.asp?pr=082&selected=21">Shibin el kom VALUE="acount.asp?pr=0471&selected=22">Sohag VALUE="acount.asp?pr=0134&selected=23">Suez VALUE="acount.asp?pr=093&selected=24">Tanta VALUE="acount.asp?pr=083&selected=25">Zagazig User Name: Password: Confirm Password: 2)- User Information Pharmacy Name: Pharmacy Owner: Address: Phone: Fax: Mobile: Email:

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