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56 lines
1.6 KiB
HTML
56 lines
1.6 KiB
HTML
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<html>
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<head>
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<title> test filedset001.html</title>
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</head>
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<body>
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fieldset and legend, sample from<br>
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http://www.w3.org/TR/WD-html40/interact/forms.html#edef-FIELDSET
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<br>Text after form
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<FORM action="..." method="post">
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<FIELDSET>
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<LEGEND align="top">Personal Information</LEGEND>
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Last Name: <INPUT name="personal_lastname" type="text" tabindex="1">
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First Name: <INPUT name="personal_firstname" type="text" tabindex="2">
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Address: <INPUT name="personal_address" type="text" tabindex="3">
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...more personal information...
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</FIELDSET>
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<FIELDSET>
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<LEGEND align="top">Medical History</LEGEND>
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<INPUT name="history_illness"
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type="checkbox"
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value="Smallpox" tabindex="20"> Smallpox</INPUT>
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<INPUT name="history_illness"
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type="checkbox"
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value="Mumps" tabindex="21"> Mumps</INPUT>
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<INPUT name="history_illness"
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type="checkbox"
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value="Dizziness" tabindex="22"> Dizziness</INPUT>
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<INPUT name="history_illness"
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type="checkbox"
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value="Sneezing" tabindex="23"> Sneezing</INPUT>
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...more medical history...
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</FIELDSET>
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<FIELDSET>
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<LEGEND align="top">Current Medication</LEGEND>
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Are you currently taking any medication?
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<INPUT name="medication_now"
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type="radio"
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value="Yes" tabindex="35">Yes</INPUT>
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<INPUT name="medication_now"
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type="radio"
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value="No" tabindex="35">No</INPUT>
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If you are currently taking medication, please indicate
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it in the space below:
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<TEXTAREA name="current_medication"
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rows="20" cols="50"
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tabindex="40">
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</TEXTAREA>
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</FIELDSET>
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</FORM>
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Text after form
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</body>
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</html>
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