37 lines
1.3 KiB
HTML
37 lines
1.3 KiB
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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<meta name="viewport" content="width=device-width, initial-scale=1">
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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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<label class="item">
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<span class="fh">Enable autofill</span>
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<input name="enable" id="enable" type="checkbox" />
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</label>
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<label class="item">
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<span class="fh">Your BahnCard 100 number</span><br />
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<span class="sh">The number on the front of your card starting with <span class="ms">7081</span>.</span><br>
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<input name="bcnum" id="bcnum" type="text" pattern="70814[0-9]{11}" required
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title="Your BahnCard number is 16 digits long and starts with 7081." />
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</label>
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<label class="item">
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<span class="fh">Your date of birth</span><br>
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<input name="birthday" id="birthday" type="date" required />
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</label>
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<label>
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<span class="fh">Skip questionnaire</span><br>
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<span class="sh">Automatically answer "I was delayed, by more than 60 minutes."</span><br>
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<input name="autocontinue" id="autocontinue" type="checkbox" />
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</label>
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<div class="item"><button type="submit">Save</button><span id="success"></span></div>
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<p id="errors"></p>
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</form>
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<script src="script.js"></script>
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</body>
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</html> |