<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>Untitled Document</title>
<style type="text/css">
body{
margin:0px;
padding:50px;
font-family:Tahoma;
}
#judul{
font-size:18px;
}
</style>
</head>
<body>
<table width="500" align="center" style="border:1px solid black">
<form method="post" action="hasil.html" >
<tr height="40" >
<td rowspan="8" width="30"></td>
<td colspan="3" align="center" id="judul">Silahkan Inputkan Data</td>
</tr>
<tr >
<td width="100" >Nama</td>
<td width="10">:</td>
<td width="350"><input type="text" name="nama" /></td>
</tr>
<tr>
<td>Alamat</td><td> :</td><td><textarea name="alamat" rows="5"></textarea></td>
</tr>
<tr>
<td>Tempat Lahir</td> <td> :</td><td> <input type="text" name="tmp_lhr" /></td>
</tr>
<tr>
<td>Tgl Lahir</td><td> : </td><td><input type="text" name="tmp_lhr" maxlength="2" size="1" />
<select name="bln_lhr">
<option value="1">Januari</option>
<option value="2">Februari</option>
<option value="3">Maret</option>
<option value="4">April</option>
<option value="5">Mei</option>
<option value="6">Juni</option>
<option value="7">Juli</option>
<option value="8">Agustus</option>
<option value="9">September</option>
<option value="10">Oktober</option>
<option value="11">Novemver</option>
<option value="12">Desember</option>
</select>
<input type="text" name="tahun" maxlength="4" size="3" /></td>
</tr>
<tr>
<td>Telepon</td><td> :</td> <td><input type="text" name="tlp" /></td>
</tr>
<tr>
<td >Jenis Kelamin</td> <td>: </td><td><input type="radio" name="lk"/>Laki-laki
<input type="radio" name="pr" />Perempuan</td>
</tr>
<tr>
<td colspan="2" align="right" height="50" ><input type="submit" value="Daftar" /></td><td><input type="reset" value="Reset" /> </td></tr>
</form>
</table>
</body>
</html>
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