<label>Is this a cell phone or a land line?</label><br>
<input type="radio"  class="radio1" name="question" value="1">Land Line</input><br>
<input type="radio"  class="radio1" name="question" value="0">Cell Phone</input>

<input type="hidden"  class="text" name="land line"></input><br>
<input type="hidden"  class="text" name="cell phone"></input><br>