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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 http-equiv="X-UA-Compatible" content="IE=edge" />
<meta name="viewport" content="width=device-width, initial-scale=1.0" />
<title>Payment Form</title>
</head>
<body>
<form action="">
<h1>Payment form</h1>
<h2>Contact Information</h2>
<p>Fields marked with * are REQUIRED.</p>
<p>Name*<input type="text" name="name" id="name" required /></p>
<fieldset required>
<legend>Gender*</legend>
<p>
Male<input type="radio" name="male" id="male"/> Female<input
type="radio"
name="female"
id="female"
/>
</p>
</fieldset>
<p>
Address<textarea
name="address"
id="address"
cols="100"
rows="8"
></textarea>
</p>
<p>Email* <input type="email" name="email" id="email" required /></p>
<p>
Pincode* <input type="number" name="pincode" id="pincode" required />
</p>
<h2>Payment Information</h2>
<p>Card Type*
<select name="card_type" id="card_type" required>
<option value="Select">Select a type</option>
<option value="Visa">Visa</option>
<option value="Maestro">Maestro</option>
<option value="MasterCard">MasterCard</option>
</select>
<p>
Card Number*<input type="number" name="card_number" id="card_number" required/>
</p>
<p>
Expiration Date*<input
type="date"
name="expiration_date"
id="expiration_date"
required
/>
</p>
<p>CVV*<input type="password" name="CVV" id="CVV"required></p>
<br>
<input type="submit" value="Pay Now" />
</form>
</body>
</html>