2024-05-20 14:40:53 +03:00
|
|
|
<!DOCTYPE html>
|
|
|
|
|
<html lang="ru">
|
|
|
|
|
<head>
|
|
|
|
|
<meta charset="UTF-8">
|
|
|
|
|
<title>Form ФИО</title>
|
|
|
|
|
</head>
|
|
|
|
|
<body>
|
2024-05-21 11:53:40 +03:00
|
|
|
<!--<form action="info.php" target="_blank" method="post">
|
2024-05-20 14:40:53 +03:00
|
|
|
Фамилия: <br>
|
|
|
|
|
<input type = "text" name = "surname" required size="50" autofocus placeholder="Фамилия"> <br> <br>
|
|
|
|
|
Имя: <br>
|
|
|
|
|
<input type = "text" name = "name" required size="50" placeholder="Имя"> <br> <br>
|
|
|
|
|
Отчество (если есть): <br>
|
|
|
|
|
<input type = "text" name = "patronymic" size="50" placeholder="Отчество"> <br> <br>
|
|
|
|
|
|
|
|
|
|
Дата Рождения: <br>
|
2024-05-21 11:53:40 +03:00
|
|
|
<input type="date" name="dateOfBirth" required> <br> <br>
|
2024-05-20 14:40:53 +03:00
|
|
|
|
|
|
|
|
Ваш пол: <br>
|
|
|
|
|
<input type="radio" name="gender" value="Мужчина" checked> Мужчина
|
|
|
|
|
<input type="radio" name="gender" value="Женжина"> Женжина<br> <br>
|
|
|
|
|
|
|
|
|
|
Номер телефона (Например 1234567890): <br>
|
|
|
|
|
<select name="countryCode">
|
|
|
|
|
<option value="+7" >Russia +7</option>
|
|
|
|
|
<option value="+38">Ukraine +38</option>
|
|
|
|
|
</select>
|
|
|
|
|
<input type="tel" name="phoneNumber" pattern="[0-9]{10}" maxlength="10" required placeholder="1234567890"> <br> <br>
|
|
|
|
|
|
|
|
|
|
Email адрес: <br>
|
|
|
|
|
<input type="Email" name="email" required> <br><br>
|
|
|
|
|
|
|
|
|
|
<input type = "submit" value="Подтвердить">
|
|
|
|
|
<input type="reset">
|
2024-05-21 11:53:40 +03:00
|
|
|
</form>-->
|
2024-05-20 14:40:53 +03:00
|
|
|
</body>
|
2024-05-21 11:53:40 +03:00
|
|
|
</html>
|
