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index.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>Document</title>
</head>
<body>
<h1>Survey for eligiblity of Students Joining LNCT Bhopal</h1>
<img src="https://tse2.mm.bing.net/th?id=OIP.waukIcpnQJzxJIYOoSxuFQHaB0&pid=Api&P=0&w=526&h=130" alt="Try again Later">
<img src="https://targetadmission.com/img/colleges/optimized/600/IMG-1-5800621.bmp" alt="Try again Later">
<form action="backend.php">
<div>
Name : <input type="text" name="myName">
</div>
<br>
<div>
Section : <input type="text" name= "myRole">
</div>
<br>
<div>
Email : <input type="text" name= "myEmail">
</div>
<br><br><br>
<div>
Date of Birth: <input type="date" name="" id="">
</div>
<br>
<div>
<h3> Gender:-</h1>
Male<input type="radio" name="myeligiblity"> Female<input type="radio" name =myeligiblity> Other<input type="radio" name="myeligiblity">
</div>
<br>
<div>
<label for="vaccine"> Have you been vaccinated?</label>
<br> <select name="myva" id="vaccine">
<option value="1st">1st Dose only</option>
<option value="Both">Both</option>
<option value="none">None</option>
</select>
</div><br>
<div>
<label for="myeligiblity"> Are u Eligible?</label>
<input type="checkbox" id="myeligiblity">
</div>
<br><br>
<div>
Suggestions for me:- <br><textarea name="myText" cols="70" rows="30"></textarea>
</div>
<br>
<div>
<input type="submit" value=" Submit Now">
<input type="reset" value="Reset Now">
</div>
<br><br><br>
<div>
<a href="https://r.search.yahoo.com/_ylt=Awr9DsxzTC9hupwAdPpXNyoA;_ylu=Y29sbwNncTEEcG9zAzIEdnRpZANEMTA0NV8xBHNlYwNzcg--/RV=2/RE=1630518515/RO=10/RU=http%3a%2f%2flnctbhopal.in%2f/RK=2/RS=xwm5iXnVAKnkE0iRrQZjgp.HYks-" target="_blank">Visit Our Site</a>
</div>
</form>
</body>
</html>