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<!DOCTYPE html> <html lang="en"> <head> <meta charset="UTF-8"> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <title>BarefootLaw Will Generator</title> <link rel="stylesheet" href="styles.css"> <link href='https://unpkg.com/boxicons@2.1.4/css/boxicons.min.css' rel='stylesheet'> <style> /* Importing fonts from Google */ @import url('https://fonts.googleapis.com/css2?family=Poppins:wght@300;400;500;600;700;800;900&display=swap'); /* Importing fonts from Google */ @import url('https://fonts.googleapis.com/css2?family=Poppins:wght@300;400;500;600;700;800;900&display=swap'); @import url('https://fonts.googleapis.com/css2?family=Poppins:wght@300;400;500;600;700;800;900&display=swap'); /* Add your custom styles here */ body { font-family: 'Poppins', sans-serif; background-color: #f3f3f3; margin: 0; padding: 0; } .container { max-width: 1000px; margin: 50px auto; background-color: #fff; box-shadow: 0 0 20px rgba(0, 0, 0, 0.1); border-radius: 10px; padding: 150px; } .form-label { font-size: 16px; color: #333; } .form-control { width: 100%; padding: 10px; margin-top: 8px; margin-bottom: 20px; border: 1px solid #ccc; border-radius: 5px; box-sizing: border-box; font-size: 13px; } .form-btn { display: block; width: 100%; padding: 12px; border: none; border-radius: 5px; background-color: #4caf50; color: #fff; font-size: 18px; cursor: pointer; } .form-btn:hover { background-color: #45a049; } .form-label.required::after { content: '*'; color: red; } .form-label.explainer::after { content: '\f6f6'; /* Unicode for lightbulb icon */ color: #ffc107; /* Yellow */ margin-left: 5px; font-family: 'boxicons'; } .legend { margin-bottom: 20px; } .legend-item { margin-right: 20px; } </style> </head> <body> <div class="container"> <h2 style="text-align: center;">BarefootLaw will generator</h2> <div class="legend"> <span class="legend-item">Required Field: <span class="form-label required"></span> </span> </div> <form action="process_will.php" method="post"> <label class="form-label required" for="fname">First Name:</label> <input type="text" id="fname" name="fname" class="form-control" required> <label class="form-label required" for="lname">Last Name:</label> <input type="text" id="lname" name="lname" class="form-control" required> <label class="form-label required" for="address">District:</label> <input type="text" id="district" name="district" class="form-control" required> <label class="form-label required" for="subcounty">Sub County:</label> <input type="text" id="subcounty" name="subcounty" class="form-control" required> <label class="form-label" for="age">Age:</label> <input type="text" id="age" name="age" class="form-control" pattern="\d*" title="Please enter only digits" required> <label class="form-label required">Gender:</label> <div class="form-control"> <label class="option"><input type="radio" name="gender" value="male"> Male</label> <label class="option"><input type="radio" name="gender" value="female"> Female</label> </div> <label class="form-label required" for="dob">Date of Birth:</label> <input type="date" id="dob" name="dob" class="form-control" required> <label class="form-label required">Marital Status:</label> <div class="form-control"> <label class="option"><input type="radio" name="marital_status" value="Married"> Married</label> <label class="option"><input type="radio" name="marital_status" value="Single"> Single</label> </div> <label class="form-label" for="spose_name">Spouse Name:</label> <input type="text" id="spouse_name" name="spouse_name" class="form-control" > <label class="spouse_age" for="spouse_age">Spouse Age:</label> <input type="text" id="spouse_age" name="spouse_age" class="form-control" > <label class="form-label" for="email">Email:</label> <input type="email" id="email" name="email" class="form-control" > <label class="form-label required" for="contact">Contact Number:</label> <input type="text" id="contact" name="contact" class="form-control" required> <button type="submit" name="subbtn" class="form-btn">Next</button> </form> </div> </body> </html>