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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>ROADIES EXAM</title>
</head>
<body>
<center>
<header> <h1>Examinee Detail.</h1> </header>
<form action="Resgistration Form">
<table>
<tr>
<td>
First Name:
</td>
<td>
<input type="text" placeholder="name">
</td>
</tr>
<tr>
<td>
Lastname:Z
</td>
<td>
<input type="text" placeholder="lastname">
</td>
</tr>
<tr>
<td>
Email:
</td>
<td>
<input type="mail" placeholder="email">
</td>
</tr>
<tr>
<td>
Password:
</td>
<td>
<input type="password" placeholder="password">
</td>
</tr>
<tr>
<td>
Date of Birth:
</td>
<td>
<input type="date" name="dob">
</td>
</tr>
<tr>
<td>
Gender:
</td>
<td>
<input type="radio" name="Gender">Male
<input type="radio" name="Gender">Female
</td>
</tr>
<tr>
<td>
State:
</td>
<td>
<input type="text" name="state" placeholder="eg.Maharashtra">
</td>
</tr>
<tr>
<td>
Country:
</td>
<td>
<input type="text" name="country" placeholder="eg.India">
</td>
</tr>
<tr>
<td>
Pincode:
</td>
<td>
<input type="text" name="pin" pattern="[0-9]{6}" placeholder="6 digit" maxlength="6">
</td>
</tr>
<tr>
<td>
Exam Date:
</td>
<td>
<input type="text" name="exam date" readonly value="2-05-2022">
</td>
</tr>
<tr>
<td>
Exam Slot:
</td>
<td>
<input type="time" name="exam time">
</td>
</tr>
<tr>
<td>
<input type="checkbox" name="checkbox" value="read status">I read the terms and conditions.
</td>
</tr>
<tr>
<td>
<input type="reset" name="clear" value="Clear">
<input type="Submit" name="Submit" value="submit">
</td>
</tr>
</table>
</form>
<disclaimer>
<h3>Disclaimer</h3>
<p>
"All the drama in this show is scripted".
</p>
</disclaimer>
</center>
</body>
</html>