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Payment_form.html
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Payment_form.html
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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>Payment Form </title>
<link rel="stylesheet" href="style/form style.css">
</head>
<body>
<div class="container">
<form action="" method="get">
<h1 class="main_heading"> Payment Form </h1>
<hr>
<h2>User Information</h2>
<p>Name:*
<input type="text" name="name" required placeholder="Ravi kumar">
</p>
<p>
<fieldset>
<legend>Gender *</legend>
Male <input type="radio" name="gender" id="Male" required>
Female <input type="radio" name="gender" id="Female" required>
</fieldset>
</p>
<p> Address:
<textarea placeholder="Enter your Address" name="address" id="address" cols="30" rows="10"></textarea>
</p>
<p>Email:*
<input placeholder="email" name="email" id="Email" required>
</p>
<p>Pincode:*
<input placeholder="number" name="pincode" id="pincode" required>
</p>
<h2> Paymet Information:</h2>
<p>Card Type: *
<select name="card_type" id="card_type">
<option value="">--select a Card Type--</option>
<option value="Visa">Visa</option>
<option value="Rupay">Rupay</option>
<option value="MasterCard">Mastercard</option>
</select>
</p>
<p>
Card Number: *
<input type="number" name="card_number" id="card_number" readonly>
</p>
<p>
Expiration Date:*
<input placeholder="dd/mm/yyyy" type="date" name="exp_date" id="exp_date" required>
</p>
<p>
CVV *
<input placeholder="123" type="password" name="cvv" id="cvv" required>
</p>
<p>
<input type="submit" value="Pay Now">
</p>
</form>
</div>
</body>
</html>