28 lines
773 B
HTML
28 lines
773 B
HTML
<!DOCTYPE html>
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<html lang="en">
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<head>
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<meta charset="UTF-8">
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<link href="style.css" rel="stylesheet" />
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</head>
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<body>
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<form>
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<fieldset>
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<label for="bcnum">The number of your BahnCard 100</label>
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<input name="bcnum" id="bcnum" type="text" pattern="70814[0-9]{11}" />
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</fieldset>
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<fieldset>
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<label for="birthday">Your date of birth</label>
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<input name="birthday" id="birthday" type="date" />
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</fieldset>
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<fieldset>
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<label for="autocontinue">Automatically continue to the "I was delayed by more than 60 minutes" screen</label>
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<input name="autocontinue" id="autocontinue" type="checkbox" />
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</fieldset>
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<button type="submit">Save</button>
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</form>
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<script src="script.js"></script>
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</body>
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</html> |