<!DOCTYPE
HTML PUBLIC "-//Microsoft // DTD//Internet explorer // HTML4.01
Transitional //EN" >
<HTML>
<HEAD>
<meta
name="author" content="Santu Das">
<meta
name="description" content="The best website…..">
<meta
name="keywords" content=" form/post/host/web">
<meta
HTTP-EQUIV="refresh" content="5; URL=second.HTML">
<TITLE>FORM</TITLE>
</HEAD>
<body
bgcolor="" link="" alink="" vlink=""
text=" ">
<form
name="" id=" " method="post"
action="receive.php">
<fieldset>
<legend
align="left">
<font
color="#AA7733"
face="time new roman" size="+3"><b>Personal
details</b></font>
</legend>
<table
border="0" bgcolor="gray" cellspacing="2" cellpadding="2"
bordercolor="gray" width="80%">
<tbody>
<tr>
<td
align="left">
<font
color="red">*</font>
First
Name  
<input
type="text" name="first_name" id="first_name"
value="Enter first name" size="15" maxlength="30"/>
</td>
<td
align="left">
<font
color="red">*</font>
Middle
Name
<input
type="text" name="middle_name" id="middle_name"
value="Ente middle name" size="15" maxlength="30"
/>
</td>
<td
align="left">
<font
color="red">*</font>
Last
Name
<input
type="text" name="Last_name" id="Last_name"
value="Enter last name" size="15" maxlength="30"/>
</td>
</tr>
<tr>
<td
align="left">
<font
color="red">*</font>
Father's
Name
<input
type="text" name="Father_name" id="Father_name"
value=" Enter Father's name" size="20" maxlength="30"
/>
</td>
<td
align="center" colspan="2">
<font
color="red">*</font>
Mother's
Name
<input
type="text" name="mother_name" id="mother_name
value="Enter mother's name"
size="20" maxlength="30" />
</td></tr><tr>
<td
align="left" colspan="2"><font
color="red">*</font>Date of Birth
<select name="date" id="date">
<option
title="- Select date-"
value="" SELECTED >- Select Date -</option>
<option
value="1">1 </option>
<option
value="2">2 </option>
<option
value="3">3 </option>
<option
value="4">4 </option>
<option
value="5">5 </option>
<option
value="6">6 </option>
<option
value="7">7 </option>
<option
value="8">8 </option>
<option
value="9">9 </option>
<option
value="10">10 </option>
<option
value="11">11 </option>
<option
value="12">12 </option>
<option
value="13">13 </option>
<option
value="14">14 </option>
<option
value="15">15 </option>
<option
value="16">16 </option>
<option
value="17">17 </option>
<option
value="18">18 </option>
<option
value="19">19 </option>
<option
value="20">20 </option>
<option
value="21">21 </option>
<option
value="22">22 </option>
<option
value="23">23 </option>
<option
value="24">24 </option>
<option
value="25">25 </option>
<option
value="26">26 </option>
<option
value="27">27 </option>
<option value="28">28
</option>
<option value="29">29
</option>
<option value="30">30
</option>
<option value="31">31
</option>
</select>
<select title="Select Month" name="mm"
id="mm">
<option
title="- Select Month -" value="" SELECTED >- Select
Month -</option>
<option
title="January" value="1" >January</option>
<option
title="February" value="2"
>February</option>
<option
title="March" value="3"
>March</option>
<option
title="April" value="4"
>April</option>
<option
title="May" value="5"
>May</option>
<option
title="June" value="6"
>June</option>
<option
title="July" value="7"
>July</option>
<option
title="August" value="8"
>August</option>
<option
title="September" value="9"
>September</option>
<option
title="October" value="10"
>October</option>
<option
title="November" value="11"
>November</option>
<option
title="December" value="12"
>December</option>
</select>
<select
title="Select year" name="yy" id="yy">
<option
title="- Select year -" value="" SELECTED >- Select year
-</option>
<option
title="1985" value="1985" >1985</option>
<option
title="1986" value="1986"
>1986</option>
<option
title="1987" value="1987"
>1987</option>
<option title="1988"
value="1988"
>1988</option>
<option
title="1989" value="1989"
>1989</option>
<option
title="1990" value="1990"
>1990</option>
<option
title="1991" value="1991"
>1991</option>
<option
title="1992" value="1992"
>1992</option>
<option
title="1993" value="1993"
>1993</option>
<option
title="1994" value="1994"
>1994</option>
<option
title="1995" value="1995"
>1995</option>
<option
title="1996" value="1996"
>1996</option>
<option
title="1997" value="1997"
>1997</option>
<option
title="1998" value="1998"
>1998</option>
<option
title="1999" value="1999"
>1999</option>
<option
title="2000" value="2000"
>2000</option>
<option
title="2001" value="2001"
>2001</option>
<option
title="2002" value="2002"
>2002</option>
<option
title="2003" value="2003"
>2003</option>
<option
title="2004" value="2004"
>2004</option>
<option
title="2005" value="2005"
>2005</option>
<option
title="2006" value="2006"
>2006</option>
<option
title="2007" value="2007"
>2007</option>
<option
title="2008" value="2008"
>2008</option>
<option
title="2009" value="2009"
>2009</option>
<option
title="2010" value="2010"
>2010</option>
<option
title="2011" value="2011"
>2011</option>
<option
title="2012" value="2012"
>2012</option>
</select>
</td>
<td
align="left">
<font
color="red">*</font>Age
<input
type="text" name="age" id="age" value="
" size="2"
maxlength="5" />
</td></tr><tr>
<td
align="left">
<p
align="left"><font
color="red">*</font>Branch
<select
name="branch" id="branch">
<option
title="-Select Branch-" value="">-Select
Branch-</option>
<option
value="MCA">MCA</option>
<option
value="BCA">BCA</option>
<option value="BCA-MCA
integrated">BCA-MCA integrated</option>
</select>
</td>
<td
align="left" colspan="2">
<font
color="red">*</font>Gender
Male<input
type="radio" name="gender" id="gender"
value="m" CHECKED/>
Female<input
type="radio" name="gneder" id="gender"
vlaue="f" />
</td>
</tr>
</tbody>
</table>
</fieldset>
<!/*************************************************************************************************************************************-->
<fieldset>
<legend
align="left">
<font
color="#AA7733" face="time new roman"
size="+3">Acedemic details</font>
</legend>
<table
border="0" bgcolor="green" cellspacing="2"
cellpadding="2" bordercolor="gray"
width="80%">
<thead><tr>
<th
align="left" bgcolor="#AACC34">
Class
</th>
<th
align="left" bgcolor="#AACC34">
Bord/University</th>
<th
align="left" bgcolor="#AACC34">
Passing
Year
</th>
<th
align="left" bgcolor="#AACC34">
Total
Marks
</th>
<th
align="left" bgcolor="#AACC34">
Percentage
</th>
</tr>
</thead><tbody>
<tr><td
align="left">
10<sup>th</sup>
</td>
<td
align="left">
<input
type="text" id="bord" name="bord"
size="15"
value="WBBSE" maxlength="20"/>
</td>
<td
align="left">
<input
type="text" id="passing_y" name="passing_y"
size="15"
value="2006" maxlength="20"/>
</td>
<td
align="left">
<input
type="text" id="mark_ob" name="mark_ob" size="15" value="
" maxlength="20"/>
</td>
<td
align="left">
<input
type="text" id="percentage" name="percentage"
size="15" value=" " maxlength="20"/>
</td>
</tr>
<tr>
<td
align="left">
12<sup>th</sup>
</td>
<td
align="left">
<input
type="text" id="bord" name="bord"
size="15"
value="WBBHSE" maxlength="20"/>
</td>
<td
align="left">
<input
type="text" id="passing_y" name="passing_y"
size="15"
value="2008" maxlength="20"/>
</td>
<td
align="left">
<input
type="text" id="mark_ob" name="mark_ob" size="15" value=" "
maxlength="20"/>
</td>
<td
align="left">
<input
type="text" id="percentage" name="percentage"
size="15" value=" " maxlength="20"/>
</td>
</tr><tr>
<td
align="left">
Graduation
</td>
<td
align="left">
<input
type="text" id="university" name="university"
size="15"
value="Vidyasagar University" maxlength="30"/>
</td>
<td
align="left">
<input
type="text" id="passing_y" name="passing_y"
size="15"
value="2011" maxlength="20"/>
</td>
<td
align="left">
<input
type="text" id="mark_ob" name="mark_ob"
size="15" value=" "
maxlength="20"/>
</td>
<td
align="left">
<input
type="text" id="percentage" name="percentage"
size="15" value=" "
maxlength="20"/>
</td>
</tr>
</tbody>
</table>
</fieldset>
<table>
<tbody>
<tr>
<td
align="center"><p id="first" name="first"
align="right">  <input
type="submit" name="submit" id="submit"
value=" Submit " />
<input
type="reset" name="reset" id="reset" value=" Reset" />
</right></td>
</tr></tbody>
</table></form>
</BODY>
</HTML>
Output:
No comments:
Write comments