forked from thesid01/Fill_Red
-
Notifications
You must be signed in to change notification settings - Fork 0
/
bloodDonate.html
32 lines (29 loc) · 1.06 KB
/
bloodDonate.html
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
<html>
<body>
<form action="blooddonate.php" method="post">
Donor Id: <input type="text" name="dId"><br>
DOnor FNAME: <input type="text" name="dFname"><br>
DOnor LNAME: <input type="text" name="dLname"><br>
BloodGroup:<select name="DBloodGroup" required id="DBloodGroup" class="form-control">
<option></option>
<option value="A+">A+</option>
<option value="A-">A-</option>
<option value="B+">B+</option>
<option value="B-">B-</option>
<option value="AB+">AB+</option>
<option value="AB-">AB-</option>
<option value="O+">O+</option>
<option value="O-">O-</option>
</select><br>
bId: <input type="text" name="bId"><br>
bType: <select name="bType" required id="bType" class="form-control">
<option></option>
<option value="Whole Blood">Whole Blood</option>
<option value="Blood Plasma">Blood Plasma</option>
<option value="OTHERS">OTHERS</option>
</select><br>
donationDate: <input type="text" name="donationDate"><br>
<input type="submit" value="Submit">
</form>
</body>
<html>