Healthy-Fy/forms.html at master · RaunakJain21/Healthy-Fy · GitHub

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<!DOCTYPE html>
<html>
  <head>
    <title>Blood Group Form</title>
    <link rel="stylesheet" type="text/css" href="css/bootstrap.css" />
  </head>
  <body>
    <div class="container">
      <div class="row col-md-6 col-md-offset-3">
        <div class="panel panel-primary">
          <div class="panel-heading text-center">
            <h1>Please fill form for Donating Blood</h1>
          </div>
          <div class="panel-body">
            <form action="connect.php" method="post">
              <div class="form-group">
                <label for="firstName">First Name</label>
                <input
                  type="text"
                  class="form-control"
                  id="firstName"
                  name="firstName"
                />
              </div>
              <div class="form-group">
                <label for="lastName">Last Name</label>
                <input
                  type="text"
                  class="form-control"
                  id="lastName"
                  name="lastName"
                />
              </div>
              <div class="form-group">
                <label for="gender">Gender</label>
                <div>
                  <label for="male" class="radio-inline"
                    ><input
                      type="radio"
                      name="gender"
                      value="m"
                      id="male"
                    />Male</label
                  >
                  <label for="female" class="radio-inline"
                    ><input
                      type="radio"
                      name="gender"
                      value="f"
                      id="female"
                    />Female</label
                  >
                  <label for="others" class="radio-inline"
                    ><input
                      type="radio"
                      name="gender"
                      value="o"
                      id="others"
                    />Others</label
                  >
                </div>
              </div>
              <div class="form-group">
                <label for="email">Email</label>
                <input
                  type="text"
                  class="form-control"
                  id="email"
                  name="email"
                />
              </div>
              <div class="form-group">
                <label for="address">address</label>
                <input
                  type="address"
                  class="form-control"
                  id="address"
                  name="address"
                />
              </div>
              <div class="form-group">
                <label for="number">Phone Number</label>
                <input
                  type="number"
                  class="form-control"
                  id="number"
                  name="number"
                />
              </div>
              <div class="form-group">
                <label for="bloodgroup"> Blood Group</label>
                <input
                  type="bloodgroup"
                  class="form-control"
                  id="bloodgroup"
                  name="bloodgroup"
                />
              </div>
              <input type="submit" class="btn btn-primary" />
            </form>
          </div>
          <div class="panel-footer text-right">
            <small>&copy;Healthy-FY.com</small>
          </div>
        </div>
      </div>
    </div>
    <div class="toast" role="alert" aria-live="assertive" aria-atomic="true">
      <div class="toast-header">
        <img src="..." class="rounded mr-2" alt="..." />
        <!-- <strong class="mr-auto">Bootstrap</strong> -->
        <!-- <small>11 mins ago</small> -->
        <button
          type="button"
          class="ml-2 mb-1 close"
          data-dismiss="toast"
          aria-label="Close"
        >
          <span aria-hidden="true">&times;</span>
        </button>
      </div>
      <!-- <div class="toast-body">Hello, world! This is a toast message.</div> -->
    </div>
  </body>
</html>