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registration.html
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83 lines (52 loc) · 2.25 KB
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<!DOCTYPE html>
<html >
<head>
<title>REGISTRATION</title>
</head>
<body>
<table border ="1" width=70% align="center">
<tr height="250px">
<td width="100">
<fieldset>
<legend><b>REGISTRATION</b></legend>
<form action="registration.php" method="POST">
<br/>
<table width="100%" >
<b>First Name</b><br>
<input type="text" name="Fname" value=""><br>
<b>Last Name</b><br>
<input type="text" name="Lname" value=""><br>
<b>Dob</b><br>
<input type="date" name="dob" > <br>
<b>Gender</b><br>
<input type="radio" name="gender" value="Male" > Male
<input type="radio" name="gender" value="Female" > Female
<input type="radio" name="gender" value="Other" > Other <br>
<b>Adress</b><br>
<input type="text" name="adress" value=""><br>
<b>Phone Number</b><br>
<input type="Number" name="phoneNumber" value=""><br>
<b>Email Adress</b><br>
<input type="email" name="email" >
<button title="hint:[email protected]" style= "color:blue;"> <b>i</b></button> <br>
<b>User Name</b><br>
<input name="userName" type="text"><br>
<b>Password</b><br>
<input type="password" name=" password" value="" ><br>
<b>Confirm Password</b><br>
<input type="password" name=" conPassword" value=""><br>
<legend> <b>User Type </b> </legend>
<input type="radio" name="UserType" value="User" > <b>User </b>
<input type="radio" name="UserType" value="Customer" > <b>Customer </b>
<input type="radio" name="UserType" value="Admin" > <b>Admin </b>
<input type="radio" name="UserType" value="Management" > <b>Management </b>
<br> <br>
<hr>
</table>
<input type="submit" name= "submit" value="Submit" style="color: green;">
<input type="reset">
</form>
</fieldset>
</table>
</body>
</html>