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form.html
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form.html
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<html>
<body>
<form action="" method="post" enctype="multipart/form-data">
<fieldset>
<label for="name">Name:</label>
<input type="text" id="name" name="name" placeholder="Enter your full name" />
<br /><br />
<label for="userid">User Id:</label>
<input type="number" id="userid" name="userid" placeholder="Enter user-id" />
<br /><br />
<label for="medicine">Medicine:</label>
<input id="medicine" name="medicine" placeholder="Enter name of medicine"></input>
<br /><br />
<label for="disease">Disease:</label>
<input id="disease" name="disease" placeholder="Enter name of disease"></input>
<br /><br />
<label for="remarks">Remarks:</label>
<textarea id="remarks" name="remarks" placeholder="Enter remarks"></textarea>
<br /><br />
<label for="hour">Hour at which to be taken</label>
<input type="number" id="hour" name="hour" placeholder="Enter hour the medicine should be taken" />
<br /><br />
<label for="minute">Minutes at which to be taken</label>
<input type="number" id="minute" name="minute" placeholder="Enter minute the medicine should be taken" />
<br /><br />
<input type="submit" value="Add timing!" />
</fieldset>
</form>
</body>
</html>