<h1><a>Form Data Diri</a></h1>
<form id="form_943208" class="appnitro" method="post" action="">
<div class="form_description">
<h2>Form Data Diri</h2>
<p></p>
</div>
<ul >
<li id="li_1" >
<label class="description" for="element_1">Nama </label>
<span>
<input id="element_1_1" name= "element_1_1" class="element text" maxlength="255" size="8" value=""/>
<label>First</label>
</span>
<span>
<input id="element_1_2" name= "element_1_2" class="element text" maxlength="255" size="14" value=""/>
<label>Last</label>
</span>
</li> <li id="li_2" >
<label class="description" for="element_2">Tanggal Lahir </label>
<span>
<input id="element_2_1" name="element_2_1" class="element text" size="2" maxlength="2" value="" type="text"> /
<label for="element_2_1">MM</label>
</span>
<span>
<input id="element_2_2" name="element_2_2" class="element text" size="2" maxlength="2" value="" type="text"> /
<label for="element_2_2">DD</label>
</span>
<span>
<input id="element_2_3" name="element_2_3" class="element text" size="4" maxlength="4" value="" type="text">
<label for="element_2_3">YYYY</label>
</span>
<span id="calendar_2">
<img id="cal_img_2" class="datepicker" src="calendar.gif" alt="Pick a date.">
</span>
<script type="text/javascript">
Calendar.setup({
inputField : "element_2_3",
baseField : "element_2",
displayArea : "calendar_2",
button : "cal_img_2",
ifFormat : "%B %e, %Y",
onSelect : selectDate
});
</script>
</li> <li id="li_5" >
<label class="description" for="element_5">Golongan Darah </label>
<span>
<input id="element_5_1" name="element_5" class="element radio" type="radio" value="1" />
<label class="choice" for="element_5_1">A</label>
<input id="element_5_2" name="element_5" class="element radio" type="radio" value="2" />
<label class="choice" for="element_5_2">AB</label>
<input id="element_5_3" name="element_5" class="element radio" type="radio" value="3" />
<label class="choice" for="element_5_3">B</label>
<input id="element_5_4" name="element_5" class="element radio" type="radio" value="4" />
<label class="choice" for="element_5_4">O</label>
</span>
</li> <li id="li_3" >
<label class="description" for="element_3">Alamat </label>
<div>
<textarea id="element_3" name="element_3" class="element textarea medium"></textarea>
</div>
</li> <li id="li_4" >
<label class="description" for="element_4">Telepon </label>
<span>
<input id="element_4_1" name="element_4_1" class="element text" size="3" maxlength="3" value="" type="text"> -
<label for="element_4_1">(###)</label>
</span>
<span>
<input id="element_4_2" name="element_4_2" class="element text" size="3" maxlength="3" value="" type="text"> -
<label for="element_4_2">###</label>
</span>
<span>
<input id="element_4_3" name="element_4_3" class="element text" size="4" maxlength="4" value="" type="text">
<label for="element_4_3">####</label>
</span>
</li>
<li class="buttons">
<input type="hidden" name="form_id" value="943208" />
<input id="saveForm" class="button_text" type="submit" name="submit" value="Submit" />
</li>
</ul>
</form>
<form id="form_943208" class="appnitro" method="post" action="">
<div class="form_description">
<h2>Form Data Diri</h2>
<p></p>
</div>
<ul >
<li id="li_1" >
<label class="description" for="element_1">Nama </label>
<span>
<input id="element_1_1" name= "element_1_1" class="element text" maxlength="255" size="8" value=""/>
<label>First</label>
</span>
<span>
<input id="element_1_2" name= "element_1_2" class="element text" maxlength="255" size="14" value=""/>
<label>Last</label>
</span>
</li> <li id="li_2" >
<label class="description" for="element_2">Tanggal Lahir </label>
<span>
<input id="element_2_1" name="element_2_1" class="element text" size="2" maxlength="2" value="" type="text"> /
<label for="element_2_1">MM</label>
</span>
<span>
<input id="element_2_2" name="element_2_2" class="element text" size="2" maxlength="2" value="" type="text"> /
<label for="element_2_2">DD</label>
</span>
<span>
<input id="element_2_3" name="element_2_3" class="element text" size="4" maxlength="4" value="" type="text">
<label for="element_2_3">YYYY</label>
</span>
<span id="calendar_2">
<img id="cal_img_2" class="datepicker" src="calendar.gif" alt="Pick a date.">
</span>
<script type="text/javascript">
Calendar.setup({
inputField : "element_2_3",
baseField : "element_2",
displayArea : "calendar_2",
button : "cal_img_2",
ifFormat : "%B %e, %Y",
onSelect : selectDate
});
</script>
</li> <li id="li_5" >
<label class="description" for="element_5">Golongan Darah </label>
<span>
<input id="element_5_1" name="element_5" class="element radio" type="radio" value="1" />
<label class="choice" for="element_5_1">A</label>
<input id="element_5_2" name="element_5" class="element radio" type="radio" value="2" />
<label class="choice" for="element_5_2">AB</label>
<input id="element_5_3" name="element_5" class="element radio" type="radio" value="3" />
<label class="choice" for="element_5_3">B</label>
<input id="element_5_4" name="element_5" class="element radio" type="radio" value="4" />
<label class="choice" for="element_5_4">O</label>
</span>
</li> <li id="li_3" >
<label class="description" for="element_3">Alamat </label>
<div>
<textarea id="element_3" name="element_3" class="element textarea medium"></textarea>
</div>
</li> <li id="li_4" >
<label class="description" for="element_4">Telepon </label>
<span>
<input id="element_4_1" name="element_4_1" class="element text" size="3" maxlength="3" value="" type="text"> -
<label for="element_4_1">(###)</label>
</span>
<span>
<input id="element_4_2" name="element_4_2" class="element text" size="3" maxlength="3" value="" type="text"> -
<label for="element_4_2">###</label>
</span>
<span>
<input id="element_4_3" name="element_4_3" class="element text" size="4" maxlength="4" value="" type="text">
<label for="element_4_3">####</label>
</span>
</li>
<li class="buttons">
<input type="hidden" name="form_id" value="943208" />
<input id="saveForm" class="button_text" type="submit" name="submit" value="Submit" />
</li>
</ul>
</form>
Atau bisa Dunlut File disini
kodenya bikin saya pusing..tpi thanks for sharing,,ini sangat membantu
Akun saya dicuri