** please note all Personal details fields must be completed ** Personal Details title (e.g. Mr/Mrs/Miss etc.) forename surname house no. or name street area postal town postcode email telephone number Treatment Details Type of Treatment: Physiotherapy Podiatry Massage Pilates Other name of therapist clinic — Please Select —[insert_php] global $wpdb; $sql=’SELECT distinct store, city, state FROM wp_wpsl_stores ORDER BY store’; $posts = $wpdb->get_results($sql); foreach ($posts as $post) { echo ‘‘.$post->store.’, ‘; if ($post->city) { echo $post->city; } else { echo $post->state.’‘; } } [/insert_php] invoice/receipt number total amount (£) additional information