<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>Untitled Document</title>
</head>
<body>
<form method="post" action="proses.html">
<table>
<tr>
<td>Nama</td>
<td>: <input type="text" name="nama_mhs" value="" /> </td>
</tr>
<tr>
<td>Alamat</td>
<td>: <textarea name="alamat"></textarea> </td>
</tr>
<tr>
<td>Tempat Lahir</td>
<td>: <input name="tmp_lahir" /> </td>
</tr>
<tr>
<td>Tgl Lahir</td>
<td>: <input name="tgl_lahir" />
<select name="bln_lahir">
<option value="1">January</option>
<option value="2">February</option>
<option value="3">March</option>
<option value="4">April</option>
<option value="5">Mei</option>
<option value="6">Juni</option>
<option value="7">Juli</option>
<option value="8">August</option>
<option value="9">September</option>
<option value="10">October</option>
<option value="11">November</option>
<option value="12">Desember</option>
</select><input type="text" name="thn_lahir" value="" /> </td>
</tr>
<tr>
<td>Telpon</td>
<td>: <input type="text" name="telpon" value=""/> </td>
</tr>
<tr>
<td>Jenis Kelamin</td>
<td>: <input type="radio" name="Jk" value="L"/>Laki-Laki
<input type="radio" name="Jk" value="P"/>Perempuan </td>
</tr>
<tr>
<td><input type="submit" name="submit" value="Daftar" /></td>
<td><input type="reset" name="reset" value="Reset" /></td>
</tr>
</table>
</form>
</body>
</html>
Tampilan yang Dihasilkan :
