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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>
<style>
*{
box-sizing: border-box;
}
body{
font-family: 'Trebuchet MS', 'Lucida Sans Unicode', 'Lucida Grande', 'Lucida Sans', Arial, sans-serif;
font-weight: 500;
margin: 15px 30px;
padding: 10px;
}
.container{
background-color: aliceblue;
padding: 5px 20px 15px 20px;
border: 4px solid aliceblue;
border-radius: 5px;
}
input[type="text"],
input[type="email"],
input[type="number"],
input[type="password"],
input[type="date"],
select,
textarea{
width: 100%;
padding: 10px;
border: 1px solid;
border-radius: 4px;
margin: 8px;
}
fieldset{
background-color: white;
border: 1px solid;
border-radius: 4px;
}
h1{
text-align: center;
font-size: 900;
}
input[type="submit"]{
background-color: teal;
border: none;
padding: 5px;
color: white;
border-radius: 4px;
cursor: pointer;
width: 100%;
}
input[type="submit"]:hover{
background-color: blueviolet;
}
</style>
</head>
<body>
<div class="container">
<form action="">
<h1>Payment Form</h1>
<hr>
<p>Required fields are followed by *</p>
<h2>Contact Information</h2>
<p>
Name: * <input type="text" name="Name" required placeholder="krish dudi">
</p>
<fieldset>
<legend>Gender * </legend>
<p>
Male <input type="radio" name="Gender" id="male" required>
Female <input type="radio" name="Gender" id="female" required>
Other <input type="radio" name="Gender" id="other" required>
</p>
</fieldset>
<p>
Address:
<br>
<textarea name="address" id="address" cols="80" rows="5" placeholder="Enter the address"></textarea>
</p>
<p>Email: * <input type="email" name="email" id="email" required placeholder="[email protected]"></p>
<p>Pincode: * <input type="number" name="pincode" id="pincode" required placeholder="123456"></p>
<hr>
<h2>Payment Information</h2>
<p>Card Type: *
<select name="card_type" id="card_type" required>
<option value="">--Select a Card Type--</option>
<option value="Rupay">Rupay</option>
<option value="Mastercard">Mastercard</option>
<option value="Visa">Visa</option>
</select>
</p>
<p>Card number: *
<input type="number" name="card_number" id="card_number" required placeholder="1111-2222-3333-4444">
</p>
<p>
Expiration Date: * <input type="date" name="exp_date" id="exp_date" required>
</p>
<p>CVV: * <input type="password" name="cvv" id="cvv" required></p>
<input type="submit" value="Pay Now">
</form>
</div>
</body>
</html>