Untitled

<style type="text/css">
html, body, p, h1, h2, h3, h4, h5, table, tr, td, th, img, ul, li {
margin: 0;
padding: 0;
border-spacing: 0;
border: 0;
border-collapse: collapse;
vertical-align: bottom;
}
h1 {padding: 10px 0 10px 210px; font-size: 160%; color: blue}
textarea {
overflow:hidden;
overflow-y: hidden;
overflow-x: hidden;
font-family: Tahoma;
}
table {margin-left: 120px;}
.ta {vertical-align: top;}
td {border-top: 20px solid white; border-right: 20px solid white;}
textarea, input {border: 1px solid silver}
input, textarea {width: 400px; font-weight: bold; font-size: 100%}
input, textarea, td, button {   font-family: Tahoma;
;font-weight: bold; font-size: 120%; font-weight: bold}
</style>
</head>
<body OnLoad="document.getElementById('focus').focus();"><div>

<table>
    <tr>
        <td>Name:</td>
        <td><input id="focus" type="text" /></td>
    </tr>
    <tr>
        <td>Date:</td>
        <td><input type="text" /></td>
    </tr>
    <tr>
        <td>Phone Number:</td>
        <td><input type="text" /></td>
    </tr>
    <tr>
        <td>Cell:</td>
        <td><input type="text" /></td>
    </tr>
    <tr>
        <td>Charger: </td>
        <td><input type="radio" name="charger" value="yes" >Yes<br>
         <input type="radio" name="charger" value="no">No<br>
         </td>

</tr>