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program.txt
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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">
<title>K Y C FORM</title>
</head>
<body>
<div align="center">
<h1>APPLICATATION K Y C FORM</h1>
<h2>Personal Details</h2>
<form name="order" method="post">
<table>
<tbody>
<td>
</tr>
<td><label>UPLOAD PHOTO</label></td>
<input type="file" name="fullname" placeholder="Enter First Name " />
<td>
<tr>
<td><label>FIRST NAME</label></td>
<td>
<input type="text" name="fullname" placeholder="Enter First Name " />
<tr>
<td><label> MIDDLE NAME</label></td>
<td>
<input type="text" name="fullname" placeholder="Enter Middle Name " />
<tr>
<td><label>LAST NAME</label></td>
<td>
<input type="text" name="fullname" placeholder="Enter Last Name " />
</td>
</tr>
<td><label>GENDER</label></td>
<td>
<input type="radio" name="addresstype" value="MALE" /> MALE
<input type="radio" name="addresstype" value="FEMALE" /> FEMALE
<input type="radio" name="addresstype" value="OTHERS" /> OTHERS
</tr>
<td><label>EMAIL ID:</label></td>
<td><input type="type" name="contact" placeholder="ENTER PHONE NUMBER"/></td>
<td>
</tr>
<td><label>NUMBER</label></td>
<td>
<input type="radio" name="addresstype" value="MOBILE NUMBER" /> MOBILE NUMBER
<input type="radio" name="addresstype" value="TELEPHONE NUMBER" /> TELEPHONE NUMBER
<td>
</tr>
<td><label>MOBILE NUMBER</label></td>
<td><input type="type" name="contact" placeholder="Enter NUMBERE"/></td>
<tr>
<td><label>DOB</label></td>
<td><input type="datetime-local" name="contact" placeholder="Enter Birth Date"/></td>
</tr>
<tr>
<table>
<tbody>
<tr>
<h2><label>Parents Details:</label></h2>
<table>
<tbody>
<td><lable>FATHER NAME :</lable></td>
<td><input type="Name" name="mail" placeholder="Enter Father Name"/></td>
</tr>
<td><label> FATHER OCCUPATION:</label></td>
<td>
<input type="text" name="fullname" placeholder="Enter OCCUPATION " />
<td>
<td><label>ANNUAL INCOME:</label></td>
<td>
<input type="text" name="fullname" placeholder="EnterINCOME" />
<td>
</tr>
<table>
<tbody>
<td><label>MOTHER NAME</label></td>
<td>
<input type="text" name="fullname" placeholder="Enter Mother Name " />
</tr>
<td><label> MOTHER OCCUPATION:</label></td>
<td>
<input type="text" name="fullname" placeholder="Enter OCCUPATION " />
<td>
<td><label>ANNUAL INCOME:</label></td>
<td>
<input type="text" name="fullname" placeholder="EnterINCOME" />
<td>
</tr>
<table>
<tbody>
<tr>
<h2 colspan="2">Proof Of Address:</h2>
</tr>
<tr>
<table>
<tbody>
<td><label>PERSON ADDRESS:</label></td>
<td>
<input type="text" name="fullname" placeholder="Enter Full Address " />
<td>
</tr>
<td><label>DISTRICT:</label></td>
<td>
<input type="text" name="fullname" placeholder="Enter District " />
<td>
</tr>
<td><lable>MANDAL:</lable></td>
<td>
<input type="text" name="fullname" placeholder="Enter Mandal " />
<td>
</tr>
<td><label>DOOR.NO:</label></td>
<td>
<input type="number" name="door" placeholder="Door number" />
<td>
</tr>
<td><label>STREET:</label></td>
<td><input type="type" placeholder="Street name" name="street"/></td>
<td>
</td>
<td>
</tr>
<td><label>PIN CODE:</label></td>
<td>
<input type="number" name="door" placeholder="enter your pincode" />
</tr>
<tr>
<table>
<tbody>
<tr>
<td><label>UPLOAD PROOF:</label></td>
<td>
<input type="file" name="door" placeholder="Door number" />
</td>
</tr>
<tr align="center">
<td>
<input type="submit" value="submit" />
<!-- <input type="button" value="Place order" /> -->
<!-- <button type="reset">
Place order
</button> -->
</td>
<td>
<input type="reset" value="cancel" />
</td>
</tr>
<tr>
<td colspan="2">
<textarea name="description"></textarea>
</td>
</tr>
</tbody>
</table>
</form>
</div>
</body>
</html>
</body>
</html>