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KLUGLUG
Blood Service Portal
Commits
ce7356d8
Commit
ce7356d8
authored
Oct 26, 2019
by
Nunna Satya Surya Venkat
Browse files
Update signup.html
parent
c89c2999
Changes
1
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signup.html
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ce7356d8
...
...
@@ -46,8 +46,19 @@
<input
type=
"text"
name=
"city"
class=
"form-control pb_height-50 reverse"
placeholder=
"City"
required
>
</div>
<div
class=
"form-group"
>
<input
type=
"number"
name=
"ago"
class=
"form-control pb_height-50 reverse"
placeholder=
"Last Donated Blood(months)"
required
>
<select
name=
"ago"
class=
"form-control pb_height-50 reverse"
required
>
<option
value=
""
selected
>
Last Donated Blood(Months)
</option>
<option
value=
"Less Than 1"
>
Less Than 1
</option>
<option
value=
"1"
>
1
</option>
<option
value=
"2"
>
2
</option>
<option
value=
"3"
>
3
</option>
<option
value=
"More Than 3"
>
More Than 3
</option>
</select>
</div>
<div
class=
"form-group"
>
<input
type=
"number"
name=
"age"
class=
"form-control pb_height-50 reverse"
placeholder=
"Age"
required
>
</div>
...
...
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