42 lines
926 B
HTML
42 lines
926 B
HTML
<!DOCTYPE html>
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<html>
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<head>
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<meta http-equiv="Content-Type" content="text/html; charset=utf-8">
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</head>
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<body>
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<form id="testform" method="post">
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<table>
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<tbody>
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<tr>
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<td>
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<label for="name">Name on Card</label>
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</td>
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<td>
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<input size="40" id="name" />
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</td>
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</tr>
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<tr>
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<td>
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<label for="number">Card Number</label>
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</td>
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<td>
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<input size="40" id="number" name="card_number" />
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</td>
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</tr>
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<tr>
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<td>
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<label>Expiration Date</label>
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</td>
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<td>
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<input size="2" id="expiration_month" name="ccmonth"> <input size="4" id="expiration_year"
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name="ccyear" />
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</td>
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</tr>
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</tbody>
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</table>
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<input type="submit" value="Submit">
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</form>
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</body>
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</html> |