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The document contains a registration form with fields for a user to enter their first name, last name, username, password, phone number, passport, date, user type, location, email, comment, gender, and a submit button. The form uses input fields like text, password, file, date, and dropdown select boxes to collect the user's registration information.

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Èdthôn Êpísõdês Êddìê
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© © All Rights Reserved
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18 views2 pages

New 1

The document contains a registration form with fields for a user to enter their first name, last name, username, password, phone number, passport, date, user type, location, email, comment, gender, and a submit button. The form uses input fields like text, password, file, date, and dropdown select boxes to collect the user's registration information.

Uploaded by

Èdthôn Êpísõdês Êddìê
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as TXT, PDF, TXT or read online on Scribd
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<form action="" method="POST">

<table>
<tr>
<td><b><label>FirstName</label></b></td>
<td> <input type="text" name="fname"></input></td>

</tr>
<tr>
<td><label><b>LastName</b></label></td>
<td> <input type="text" name="lname"></input></td>
</tr>
<tr>
<td><b><label>UserName</label></b></td>
<td> <input type="text" name="username" required></input></td>

</tr>
<tr>
<td><label><b>Password</b></label></td>
<td> <input type="password" name="password" required></input></td>
</tr>
<tr>
<tr>
<td><b><label>phoneNumber</label></b></td>
<td> <input type="text" name="phone" required></input></td>

</tr>
<tr>
<td><label><b>passpor</b></label></td>
<td> <input type="file" name="photo" required></input></td>
</tr>
<tr>
<td><label><b>Date</b></label></td>
<td> <input type="Date" name="date" required></input></td>
</tr>

<div id="login">

<tr>
<td><label><b>UserType</b></label></td>
<td><select name="userType">
<option value="customer">customer</option>

</select></td>
</tr>
<tr>
<td><label>location Adress</label></td>
<td><input type="text" name="location" required></input></ </td>
</tr>

<tr>
<td><label>Contact email</label></td>
<td><input type ="text" name="email" required></input></ </td>
</tr>

<tr>
<td><label>Comment</label></td>
<td><textarea row="4" name="comment"></textarea> </td>
</tr>

<tr>
<td><label><b>gender</b></label></td>
<td><select name="gender">
<option value="male">male</option>
<option value="female">female</option>

</select></td>
</tr>

<tr>
<td><label><b>submit</b></label></td>
<td><input type="submit" value="login" ></input></td>
</tr>

</table>
</form>

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