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help.html
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help.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>need help??</title>
<style>
*{
margin: 0;
padding: 0;
box-sizing: border-box;
text-decoration: none;
}
.beg{
width: 100%;
padding: 24px;
}
h2{
text-align: center;
padding-left: 30px;
font-family: 'Times New Roman', Times, serif;
font-size: 25px;
margin-bottom: 20px;
color: brown;
}
.form-heading{
text-align: center;
font-size: 35px;
padding: 10px 10px 25px 10px;
}
main{
padding: 24px;
}
form{
background-color: white;
width: 650px;
margin: auto;
font-size: 25px;
font-family: 'Franklin Gothic Medium', 'Arial Narrow', Arial, sans-serif;
padding: 16px;
border: 3px solid transparent ;
border-radius: 10px;
box-shadow: 2px 2px 10px white;
margin-bottom: 40px;
letter-spacing: 2px;
}
form:hover{
background-color: black;
transform: scale(1.08);
color: blanchedalmond;
box-shadow: 2px 2px 10px black;
}
.form-element{
width: 100%;
padding: 16px;
}
.fullname, .email, .age, .aadhar, .City, .contact{
width: 100%;
padding: 12px;
font-size: 25px;
letter-spacing: 5px;
border-top: none;
border-left: none;
border-right: none;
}
.label{
padding: 10px 10px 10px 0;
}
#submit-button{
text-align: center;
font-size: 30px;
color: azure;
background-color: transparent;
background-color: lightgreen;
width: 200px;
padding: 10px;
border: 1px solid transparent;
border-radius: 5px;
}
#submit-button:hover{
transform: scale(1.3);
background-color: rgb(84, 235, 84);
cursor: pointer;
}
#button{
text-align: center;
margin-top: 40px;
margin-bottom: 50px;
}
.state{
width: 100%;
font-size: 20px;
padding: 16px;
border-radius: 5px;
letter-spacing: 3px;
}
.state:hover{
background-color: lightcyan;
}
#covid{
width: 50%;
font-size: 20px;
padding: 16px;
border-radius: 5px;
letter-spacing: 3px;
}
#covid:hover{
background-color: lightcyan;
}
input:focus{
border: none;
background-color: lightcyan;
}
</style>
</head>
<body style="background-color: rgb(189, 213, 245);">
<div class="beg">
<h2>If You need Any Kind of help in this Pandemic, Do let us know by submitting the Help Form below
<br>After submitting we will contact you within 48 hours.....
</h2>
</div>
<main>
<form action="https://docs.google.com/forms/u/0/d/e/1FAIpQLScRLQ_x47-gd7cAKrbkhGonhowYfZFqUcUiXdDNiuWrVGhlAw/formResponse" target="_self" method="POST">
<p class="form-heading" style="color: red;">HELP FORM</p>
<div class="form-element">
<input class="fullname" type="text" placeholder="Full name" name="entry.1874162764" autofocus required>
</div>
<div class="form-element">
<input class="email" type="email" placeholder="Email" name="entry.1409502905" required>
</div>
<div class="form-element">
<input class="age" type="number" placeholder="Age" name="entry.1121584150" max="100">
</div>
<div class="form-element">
<input class="aadhar" type="number" placeholder="Aadhar Number" name="entry.31421457" required>
</div>
<div class="form-element">
<p class="label">Gender:</p>
<input class="form-radio" type="radio" name="entry.53107064" value="male"> male
<input class="form-radio" type="radio" name="entry.53107064" value="female"> female
<input class="form-radio" type="radio" name="entry.53107064" value="other"> other
</div>
<div class="form-element">
<p class="label" name="entry.590495310">State:</p>
<select class="state" name="entry.964344647" required>
<option value="None">None</option>
<option value="Andra Pradesh">Andra Pradesh</option>
<option value="Arunachal Pradesh">Arunachal Pradesh</option>
<option value="Assam">Assam</option>
<option value="Bihar">Bihar</option>
<option value="Chhattisgarh">Chhattisgarh</option>
<option value="Goa">Goa</option>
<option value="Gujarat">Gujarat</option>
<option value="Haryana">Haryana</option>
<option value="Himachal Pradesh">Himachal Pradesh</option>
<option value="Jharkhand">Jharkhand</option>
<option value="Karnataka">Karnataka</option>
<option value="Kerala">Kerala</option>
<option value="Madhya Pradesh">Madhya Pradesh</option>
<option value="Maharashtra">Maharashtra</option>
<option value="Manipur">Manipur</option>
<option value="Meghalaya">Meghalaya</option>
<option value="Mizoram">Mizoram</option>
<option value="Nagaland">Nagaland</option>
<option value="Odisha">Odisha</option>
<option value="Punjab">Punjab</option>
<option value="Rajasthan">Rajasthan</option>
<option value="Sikkim">Sikkim</option>
<option value="Tamil Nadu">Tamil Nadu</option>
<option value="Telangana">Telangana</option>
<option value="Tripura">Tripura</option>
<option value="Uttar Pradesh">Uttar Pradesh</option>
<option value="Uttrakhand">Uttrakhand</option>
<option value="West Bengal">West Bengal</option>
</select>
</div>
<div class="form-element">
<input class="City" type="text" placeholder="City" name="entry.1623505885" required>
</div>
<div class="form-element">
<p class="label" name="entry.772656368">Are you Corona Positive?</p>
<select class="label" name="entry.117289183" id="covid" required>
<option value="dont Know">don't Know</option>
<option value="yes">yes</option>
<option value="no">no</option>
</select>
</div>
<div class="form-element">
<input class="contact" type="number" placeholder="Phone Number" name="entry.1553642365" required>
</div>
<div id="button" class="form-element">
<input id="submit-button" type="submit" value="SUBMIT">
</div>
</form>
</main>
<footer style="font-size: 20px; padding: 18px; background-color: lightgray ; text-align: center;">
<a href="index.html"><input type="button" value="Home Page" style="font-size: 15px; padding:5px; background-color: azure;"></a>
<p>©created by Arman </p>
<p><strong>email : </strong><i><a href="mailto:alikhanarman786@gmail.com">alikhanarman786@gmail.com</a><p>
</footer>
</body>
</html>