Error Code!

PHP
1

Dears, i have the following code for my landing pages that will push the information to SugarCRM, for some reason and i dont know why, when a client register it sometimes the client information appears empty in my sugarcrm, can you please help to identify the issue.
the code is:

<form onsubmit="return validateForm()" action="http://---------.net/crm/index.php?entryPoint=WebToLeadCapture" name="WebToLeadForm" method="POST" id="contact_form" name="myForm">
     <div id="result"></div>
	<input type="text" name="last_name" id="last_name" placeholder="اسمك هنا" class="pix_text" required>
	     <div dir="rtl" style="display:none; color: whitesmoke; !important;" id="name-valid1" class="alert alert-danger">الرجاء ادخال الاسم بشكل صحيح</div>
	     <input type="email" name="email1" id="email1" placeholder="بريدك الالكتروني هنا" class="pix_text" required>
	     <div dir="rtl" style="display:none; color: whitesmoke; !important;"id="email-valid1"  class="alert alert-danger">الرجاء ادخال البريد الالكتروني بشكل صحيح</div>
	     <input type="text" name="phone_mobile" id="phone_mobile" placeholder="رقم هاتفك هنا" class="pix_text" pattern="[0-9]{10}" required>
	     <button class="subscribe_btn pix_text" onclick="submit_form()" id="submitform">
	          <span class="editContent">أرسل بياناتك الآن</span>
             </button>							
             <div dir="rtl" style="display:none; color: whitesmoke; !important;"id="phone-valid1"  class="alert alert-danger">الرجاء ادخال رقم الهاتف بشكل صحيح</div>
             <input type="hidden" id="lead_source" name="lead_source" value="sitedisplay">
             <input type="hidden" id="campaign_id" name="campaign_id" value="9189b8f0-2729-ba7c-d17c-55b34c5fc40b" />
             <input id="assigned_user_id" type="hidden" name="assigned_user_id" value="1" />

             <input type="hidden" id="redirect_url" name="redirect_url" value="http://--------.com/thankYouPage">
	     <?php
		  $client  = @$_SERVER['HTTP_CLIENT_IP'];
		  $forward = @$_SERVER['HTTP_X_FORWARDED_FOR'];
		  $remote  = @$_SERVER['REMOTE_ADDR'];
		  $result  = array('country'=>'', 'city'=>'');
		  if(filter_var($client, FILTER_VALIDATE_IP)){
			$ip = $client;
		  }elseif(filter_var($forward, FILTER_VALIDATE_IP)){
			$ip = $forward;
		  }else{
			$ip = $remote;
		  }
		  $ip_data = @json_decode(file_get_contents("http://www.geoplugin.net/json.gp?ip=".$ip));    
		  if($ip_data && $ip_data->geoplugin_countryName != null){
		       $result['country'] = $ip_data->geoplugin_countryCode;
		       $result['city'] = $ip_data->geoplugin_city;
		  }
								
            ?>
     <br>
     <input type="hidden" name="primary_address_country" id="primary_address_country" value="<?php echo $result['country'].",".$result['city']; ?>">
</form>
<script>
function validateForm1() {
	var x = $("#last_name1").val();
	var y = $("#phone_mobile1").val();
	var z = $("#email11").val();
	var x1 = 0; x2 = 0; x3 = 0;
    if (x == null || x == "" || y == null || y == "" || z == null || z == "" ) {
        $("#name-valid1").show(300).delay(3000).hide(300);
        $("#email-valid1").show(300).delay(3000).hide(300);
        $("#phone-valid1").show(300).delay(3000).hide(300);
	
        return false;
    } else {
		x1 = 1;
	}
	if(!y.match(/\d{10}/g)) {
        $("#phone-valid1").show(300).delay(3000).hide(300);
	
        return false;
	} else {
		x2 = 1;
	}
	if(!z.match(/\S+@\S+\.\S+/i)) {	
        $("#email-valid1").show(300).delay(3000).slideUp(300);
		
        return false;
	} else {
		x3 = 1;
	}
	if(x1 == 1 && x2 == 1 && x3 == 1){
		$("#submitb").attr('disabled','disabled');
    
		return true;
	}
}
</script>
2

Which data ‘appears empty’?

Also an aside, you dont need the x1,x2,x3 or any of the 'else’s in your code at the bottom there - if you encounter a fail state, you return from the function before you even get to the if.

3

the name, email and the phone number

4

That would make sense. The function is using id selectors that don’t exist in the form.

5

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