rezamalik15

registration_form.blade.php

Jul 15th, 2023
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  1. <!DOCTYPE html>
  2. <html lang="en">
  3. <head>
  4.     <meta charset="UTF-8">
  5.     <meta name="viewport" content="width=device-width, initial-scale=1.0">
  6.     <meta http-equiv="X-UA-Compatible" content="ie=edge">
  7.     <title>Register</title>
  8.     <link href="https://cdn.jsdelivr.net/npm/[email protected]/dist/css/bootstrap.min.css" rel="stylesheet" integrity="sha384-9ndCyUaIbzAi2FUVXJi0CjmCapSmO7SnpJef0486qhLnuZ2cdeRhO02iuK6FUUVM" crossorigin="anonymous">
  9. </head>
  10. <body>
  11.  
  12.     <div class="container ">
  13.  
  14.         <div class="position-absolute top-50 start-50 translate-middle w-50 shadow p-3">
  15.  
  16.             <form action="/register/add" method="post">
  17.                 @csrf
  18.  
  19.                 <h2 class="text-center">Daftar Di sini</h2>
  20.    
  21.                 <div class="mb-3">
  22.                     <label for="name">Nama</label>
  23.                     <input class="form-control col" type="text" id="name" placeholder="Nama Lengkap" name="name">
  24.                 </div>
  25.  
  26.                 <div class="mb-3">
  27.                     <label for="pob">Tempat Lahir</label>
  28.                     <input class="form-control col" type="text" id="pob" placeholder="Kota tempat lahir" name="pob">
  29.                 </div>
  30.  
  31.                 <div class="mb-3">
  32.                     <label for="dob">Tanggal Lahir</label>
  33.                     <input class="form-control col" type="date" id="dob" name="dob">
  34.                 </div>
  35.  
  36.                 <div class="mb-3">
  37.                     <label>Jenis Kelamin</label>
  38.                     <div class="form-check mb-2">
  39.                         <input class="form-check-input" type="radio" name="gender" id="male" value="1">
  40.                         <label class="form-check-label" for="male">Laki - Laki</label>
  41.                     </div>
  42.                     <div class="form-check">
  43.                         <input class="form-check-input" type="radio" name="gender" id="female" value="0">
  44.                         <label class="form-check-label" for="female">Perempuan</label>
  45.                     </div>
  46.                 </div>
  47.  
  48.                 <div class="mb-3">
  49.                     <label for="email">Email</label>
  50.                     <input class="form-control col" type="email" id="email" name="email">
  51.                 </div>
  52.  
  53.                 <div class="mb-3">
  54.                     <label for="phone">Nomor Telepon</label>
  55.                     <input class="form-control col" type="text" id="dob" name="phone">
  56.                 </div>
  57.  
  58.                 <div class="mb-3">
  59.                     <input class="btn btn-primary col-12" type="submit" id="submit" value="Daftar">
  60.                 </div>
  61.    
  62.             </form>
  63.  
  64.         </div>
  65.  
  66.     </div>
  67.  
  68.     <script src="https://cdn.jsdelivr.net/npm/[email protected]/dist/js/bootstrap.bundle.min.js" integrity="sha384-geWF76RCwLtnZ8qwWowPQNguL3RmwHVBC9FhGdlKrxdiJJigb/j/68SIy3Te4Bkz" crossorigin="anonymous"></script>  
  69.    
  70. </body>
  71. </html>
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