- Script Input
- <!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>Untitled Document</title>
</head>
<body>
<form id="form1" name="form1" method="post" action="inputktp.php">
<table width="279" border="1">
<tr>
<td colspan="3" align="center">INPUT DATA PENDUDUK</td>
</tr>
<tr>
<td width="98"><div align="left">NIK</div></td>
<td width="4">:</td>
<td width="155"><label>
<input type="text" name="nik" id="nik" />
</label></td>
</tr>
<tr>
<td><div align="left">Nama</div></td>
<td>:</td>
<td><label>
<input type="text" name="nama" id="nama" />
</label></td>
</tr>
<tr>
<td><div align="left">Tanggal Lahir</div></td>
<td>:</td>
<td><label>
<input type="text" name="tanggallahir" id="tanggallahir" />
</label></td>
</tr>
<tr>
<td><div align="left">Tempat Lahir</div></td>
<td>:</td>
<td><label>
<input type="text" name="tempatlahir" id="tempatlahir" />
</label></td>
</tr>
<tr>
<td><div align="left">Agama</div></td>
<td>:</td>
<td><label>
<input type="text" name="agama" id="agama" />
</label></td>
</tr>
<tr>
<td><div align="left">Alamat</div></td>
<td>:</td>
<td><label>
<input type="text" name="alamat" id="alamat" />
</label></td>
</tr>
<tr>
<td><div align="left">Jenis Kelamin</div></td>
<td>:</td>
<td><label>
<select name="jeniskelamin" id="jeniskelamin">
<option value="Pria">Pria</option>
<option value="Wanita">Wanita</option>
</select>
</label></td>
</tr>
<td><div align="left">Status</div></td>
<td>:</td>
<td><label>
<select name="status" id="status">
<option value="Lajang">Lajang</option>
<option value="Sudah Menikah">Sudah Menikah</option>
</select>
</label></td>
</tr>
<tr>
<td><div align="left">Gol. Darah</div></td>
<td>:</td>
<td><label>
<input type="text" name="goldarah" id="goldarah" />
</label></td>
</tr>
<tr>
<td> </td>
<td> </td>
<td><label>
<input type="submit" name="button" id="button" value="Simpan" />
</label></td>
</tr>
</table>
</form>
</body>
</html>
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