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signup.html
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signup.html
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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<link
rel="stylesheet"
href="https://maxcdn.bootstrapcdn.com/bootstrap/4.5.2/css/bootstrap.min.css"
/>
<script src="https://ajax.googleapis.com/ajax/libs/jquery/3.5.1/jquery.min.js"></script>
<script src="https://maxcdn.bootstrapcdn.com/bootstrap/3.4.1/js/bootstrap.min.js"></script>
<link rel="preconnect" href="https://fonts.googleapis.com" />
<link rel="preconnect" href="https://fonts.gstatic.com" crossorigin />
<link href="https://fonts.googleapis.com/css2?family=Fuggles&family=Indie+Flower&display=swap" rel="stylesheet">
<link
href="https://fonts.googleapis.com/css2?family=Josefin+Sans:wght@100;200;500&display=swap"
rel="stylesheet"
/>
<link href="https://fonts.googleapis.com/css2?family=Dancing+Script:wght@600&display=swap" rel="stylesheet">
<link href="https://fonts.googleapis.com/css2?family=Alfa+Slab+One&display=swap" rel="stylesheet">
<title>Health Bliss Signup </title>
<!-- font awesome cdn link -->
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/5.15.3/css/all.min.css">
<!-- custom css file link -->
<link rel="stylesheet" href="styles1.css">
<link rel="shortcut icon" href="icon.png" />
</head>
<body style="background: #ededed;">
<p style="text-align: center;color:blueviolet; font-size: 25px; font-family: Georgia, 'Times New Roman', Times, serif;"> SIGNUP PAGE - HEALTH BLISS</p>
<div style="margin:auto;">
<div>
<img src="anxiety.png" style="width: 650px;height: 600px;margin-left: 75px; float: left;">
</div>
<div class="signupcontainer">
<div class="contentbox1">
<form name="myform" id="sign" onsubmit="validateform()" method="POST">
<div class="label2">
<label>Name</label>
<input
id="inputbox2"
type="text"
name="name"
class="form-control"
size="50"
required
/>
</div>
<div class="label2">
<label>Age</label>
<input
id="inputbox2"
type="text"
name="dob"
class="form-control"
required
/>
</div>
<div class="label2">
<label>Gender</label><br/>
<input type="radio" id="cat1" name="gender" value="Male"> <label for="cat1">Male</label>
<input type="radio" id="cat2" name="gender" value="female"> <label for="cat2">Female</label>
<input type="radio" id="cat3" name="gender" value="others"> <label for="cat3">Others</label>
</div>
<!--<div class="label2">
<label>Vaccination status:</label><br />
<input type="radio" id="cat1" name="vaccine" value="one"> <label for="cat1">2 doses </label>
<input type="radio" id="cat2" name="vaccine" value="two"> <label for="cat2">1 dose </label>
<input type="radio" id="cat3" name="vaccine" value="none"> <label for="cat3">Not taken yet</label>
</div> -->
<div class="label2">
<label>E-mail</label>
<input
id="inputbox2"
type="text"
name="email"
class="form-control"
required
/>
</div>
<div class="label2">
<label>Password</label>
<input
id="inputbox2"
type="password"
id="password"
name="password"
pattern="(?=.*\d)(?=.*[a-z])(?=.*[A-Z]).{6,}"
title="Must contain at least one number and one uppercase and lowercase letter, and at least 6 or more characters"
required
class="form-control"
/>
</div>
<div>
<button type="submit" value="register" class="signupbutton">
SIGN-UP
</button>
</div>
</form>
</div>
</div>
</body>
</html>