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| 1 | +<!DOCTYPE html> |
| 2 | +<html lang="es-cl"> |
| 3 | + <head> |
| 4 | + <meta charset="UTF-8" /> |
| 5 | + <meta name="viewport" content="width=device-width, initial-scale=1.0" /> |
| 6 | + <title>Formulario Bootstrap</title> |
| 7 | + <link |
| 8 | + href="https://cdn.jsdelivr.net/npm/bootstrap@5.3.3/dist/css/bootstrap.min.css" |
| 9 | + rel="stylesheet" |
| 10 | + integrity="sha384-QWTKZyjpPEjISv5WaRU9OFeRpok6YctnYmDr5pNlyT2bRjXh0JMhjY6hW+ALEwIH" |
| 11 | + crossorigin="anonymous" |
| 12 | + /> |
| 13 | + </head> |
| 14 | + <body> |
| 15 | + <main> |
| 16 | + <div class="container my-4"> |
| 17 | + <form action="./filled-form.html" class="row g-3" id="userForm"> |
| 18 | + <div class="col-md-4"> |
| 19 | + <label for="userName" class="form-label">Nombre</label> |
| 20 | + <input |
| 21 | + type="text" |
| 22 | + class="form-control" |
| 23 | + id="userName" |
| 24 | + placeholder="Armin" |
| 25 | + required |
| 26 | + /> |
| 27 | + </div> |
| 28 | + |
| 29 | + <div class="col-md-4"> |
| 30 | + <label for="userSurname" class="form-label">Apellido</label> |
| 31 | + <input |
| 32 | + type="text" |
| 33 | + class="form-control" |
| 34 | + id="userSurname" |
| 35 | + placeholder="Cano" |
| 36 | + required |
| 37 | + /> |
| 38 | + </div> |
| 39 | + |
| 40 | + <div class="col-md-4"> |
| 41 | + <label for="userNameOfUser" class="form-label" |
| 42 | + >Nombre de usuario</label |
| 43 | + > |
| 44 | + <div class="input-group mb-3"> |
| 45 | + <span class="input-group-text">@</span> |
| 46 | + <input |
| 47 | + type="text" |
| 48 | + class="form-control" |
| 49 | + id="userNameOfUser" |
| 50 | + placeholder="armincano" |
| 51 | + aria-label="nombre de usuario" |
| 52 | + required |
| 53 | + /> |
| 54 | + </div> |
| 55 | + </div> |
| 56 | + |
| 57 | + <div class="col-md-6"> |
| 58 | + <label for="userCity" class="form-label">Ciudad</label> |
| 59 | + <input |
| 60 | + type="text" |
| 61 | + class="form-control" |
| 62 | + id="userCity" |
| 63 | + placeholder="Villarrica" |
| 64 | + required |
| 65 | + /> |
| 66 | + </div> |
| 67 | + |
| 68 | + <div class="col-md-3"> |
| 69 | + <label for="reasonSelect" class="form-label">Motivo</label> |
| 70 | + <select |
| 71 | + class="form-select" |
| 72 | + id="reasonSelect" |
| 73 | + aria-label="Default select example" |
| 74 | + > |
| 75 | + <option selected>Depósito</option> |
| 76 | + <option value="1">Giro</option> |
| 77 | + <option value="2">Consulta de Saldo</option> |
| 78 | + </select> |
| 79 | + </div> |
| 80 | + |
| 81 | + <div class="col-md-5"> |
| 82 | + <label class="form-check-label" for="areAnswersShown"> |
| 83 | + ¿Desea ver la respuesta en pantalla? |
| 84 | + </label> |
| 85 | + <div class="form-check"> |
| 86 | + <input |
| 87 | + class="form-check-input" |
| 88 | + type="checkbox" |
| 89 | + value="showAnswers" |
| 90 | + id="areAnswersShown" |
| 91 | + checked |
| 92 | + />Si |
| 93 | + </div> |
| 94 | + </div> |
| 95 | + |
| 96 | + <div class="col-md-12"> |
| 97 | + <button type="submit" class="btn btn-primary mb-3"> |
| 98 | + Solicitar |
| 99 | + </button> |
| 100 | + </div> |
| 101 | + </form> |
| 102 | + </div> |
| 103 | + </main> |
| 104 | + |
| 105 | + <script |
| 106 | + src="https://cdn.jsdelivr.net/npm/bootstrap@5.3.3/dist/js/bootstrap.bundle.min.js" |
| 107 | + integrity="sha384-YvpcrYf0tY3lHB60NNkmXc5s9fDVZLESaAA55NDzOxhy9GkcIdslK1eN7N6jIeHz" |
| 108 | + crossorigin="anonymous" |
| 109 | + ></script> |
| 110 | + </body> |
| 111 | +</html> |
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