Designig Data collecting form

This project is about constructing an electronic form that is accessible from different PC and stores the data in the main server over the intranet. the script should be able to be placed in a subdomain. Main page should Say Dialysis Event Form Submission System & under that fields to log in as an admin or user. If you log in as a user you only get to submit the form attached. Each form should also have a surname, firstname, Date of birth & file number fields. Admin have access to the following. Admin should be able to do the following functions: 1-adding more users & can adjust passwords. Admin can also give limited or unlimited button to users. An unlimited user should be able to have similar functions to admin other than limiting & unlimiting users. 2-search forms by name, DOB or file number, retrieve them and adjust them. ( if the form is retrieved and adjusted the collected data should be corrected) 3-view stats of entered data based on all time or specific time ( viewed similar to excel) & be able to print them. For instance : Swab taken yes 10 Swab taken no 7. The organisms form 2nd page user should tick infornt of organism found only. then each letter of SIRN should have a tick box. Only ticked organism and data is shown in stats. unclicked organism or drug should not be included. 25% will be paid upon closing and choosing the [login to view URL] will be cleared upon finishing the project. If you win you should be available to correct any bugs for 2 months time. Programming should be open source & easily adjustable. you must provide clear instruction on installation. Any questions ask before you bid. Thank for interest.