Untitled

<!DOCTYPE html>
<html lang = "pl">
<head>
<meta charset = "utf-8" />
<title>Rejestracja klienta</title>
</head>
<body>
<form action = "http://localhost/dodaj_klienta.php" method = "post">
	<p><b><font size ="4">Rejestracja klienta:</b></p>
	Nazwisko: <br />
	<input type = "text" name = "nazw" value = "" size = "30" /><br />
	Imię: <br />
	<input type = "text" name = "im" value = "" size = "30" /><br />
	Kod pocztowy: <br />
	<input type = "text" name = "kod" value = "" size = "5" /><br />
	Miejscowość: <br />
	<input type = "text" name = "mia" value = "" size = "30" /><br />
	Ulica: <br />
	<input type = "text" name = "ul" value = "" size = "30" /><br />
	Numer domu: <br />
	<input type = "text" name = "nr" value = "" size = "7" /><br />
	PESEL: <br />
	<input type = "text" name = "pe" value = "" size = "11" /><br />
	Numer telefonu: <br />
	<input type = "text" name = "tel" value = "" size = "9" /><br />
	Adres e-mail: <br />
	<input type = "text" name = "adr" value = "" size = "30" /><br />
	<p><input type = "submit" value = "Wyślij" name = "wyslij" />
	<input type = "reset" value = "Wyczyść" name = "zeruj" /></p>
</form>
</body>
</html>