JQueryData/Demo2.html at master · ulhas1991/JQueryData · GitHub

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<!doctype html>
<html>
<head>
        <title> Telangana Family survey </title>
</head>
<body style="background-color: pink">
    <div>
            <img src="C:\Users\Ulhas\Desktop\Telengana.jpg" width="100px" height="100px">
    </div>
    <h1 style="  text-align: center;"> Telangana Family survey</h1>
        <form action=”demo_form.asp”  method=”POST”>
House Number: <input type=”text” name=”HouseNumber” size=10 maxlength=10><br>
Onwer Name: <input type=”text” name=”OnwerName” size=10 maxlength=10 ><br>
Tolat Family members: <input type=”text” name=”Totalfamilymembers” ><br>

Do you have LPG:
<select status=”LPG”>
<OPTION VALUE=YES>YES</OPTION>
<OPTION VALUE=NO>NO</OPTION>
</select><br>
LPG Connection Number: <input type=”text” name=”HouseNumber” size=10 maxlength=10><br>
WaterConnection:
<select status=”waterconnection”>
<OPTION VALUE=YES>YES</OPTION>
<OPTION VALUE=NO>NO</OPTION>
</select><br>
Water Connection Number: <input type=”text” name=”HouseNumber” size=10 maxlength=10><br>

ElectricityConnection:
<select status=”ElectricityConnection”>
<OPTION VALUE=YES>YES</OPTION>
<OPTION VALUE=NO>NO</OPTION>
</select><br>
Electricity Connection Number: <input type=”text” name=”HouseNumber” size=10 maxlength=10><br>

BankAccountNumber:
<select status=”BankAccount”>
<OPTION VALUE=YES>YES</OPTION>
<OPTION VALUE=NO>NO</OPTION>
</select><br>
BankAccount Number: <input type=”text” name=”HouseNumber” size=10 maxlength=10><br>


AadharCard
<select status=”AadharCardd”>
<OPTION VALUE=YES>YES</OPTION>
<OPTION VALUE=NO>NO</OPTION>
</select><br>
AadharCard Number: <input type=”text” name=”HouseNumber” size=10 maxlength=10><br>

Cast
<input type="radio" value="SC">SC
<input type="radio" value="OBC">OBC
<input type="radio" value="ST">ST
<input type="radio" value="BC">BC
<input type="radio" value="OC">OC
<br>
BirthCertificate
<select status=BirthCertificate>
<OPTION VALUE=YES>YES</OPTION>
<OPTION VALUE=NO>NO</OPTION>
</select><br>
BirthCertificate Number: <input type=”text” name=”HouseNumber” size=10 maxlength=10><br>
<br>
Vehicle:
<input type="checkbox" value="cycle">Cycle
<input type="checkbox" value="Two-Wheeler">Two-Wheeler
<input type="checkbox" value="Three-Wheeler">Three-Wheeler
<input type="checkbox" value="Four-Wheeler">Four-Wheeler
<br>
AirCondition:
<select status=AirCondition>
<OPTION VALUE=YES>YES</OPTION>
<OPTION VALUE=NO>NO</OPTION>
</select><br>

Agricultural Land
<select status=Agriculturalland>
<OPTION VALUE=YES>YES</OPTION>
<OPTION VALUE=NO>NO</OPTION>
</select><br>
Passbook Number: <input type=”text” name=”HouseNumber” size=10 maxlength=10><br>
Revenue Village: <input type=”text” name=”HouseNumber” size=10 maxlength=10><br>
District: <input type=”text” name=”HouseNumber” size=10 maxlength=10><br>
<br>
OwnHouse
<select status=OwnHouse>
<OPTION VALUE=YES>YES</OPTION>
<OPTION VALUE=NO>NO</OPTION>
</select><br>
House Number: <input type=”text” name=”HouseNumber” size=10 maxlength=10><br>
Number of Houses: <input type=”text” name=”HouseNumber” size=10 maxlength=10><br>


</form>
</body>
</html>