Write an HTML Form to input a new patient information in a hospital. The form will have no action.

The form should ask the new patient for the following:

His name $($first$,$ middle, last$)($use input of type text here$)$

Age $($Use input of type number here$)$

Gender $($use a select here$)$

Date of birth $($use an input of type date for this field$)$

Address $...$

Phone number $($Use an input of type tel here, and apply a pattern$)$

Time of arrival $($Use input of type time here$)$

Type of insurance $...$

Previous illnesses $($A select with multiple selections$)$

Number of previous visits $($Radio buttons$)($first time or $1-5$ or $5-10$ or more than $10)$

Drugs he is currently taking $...$

Allergies if any $($Check boxes$)$

Complaint $($text area$)$

Degree of the pain he is feeling right now $($from $1-10)($Use input of type range$)$

Email $($use input of type email$)$

Password $($use input of type password here$)$

Re$-$type the password

A submit button

A reset button

A button called "Check" when clicked will make sure that the password and the re$-$type of the password are the same. $($Hint: Use a JavaScript function to do that onClick$)$

Make sure that the password is more than $8$ characters, has capital and small letters, has digits, and at least one special character.

The HTML $$form$>$ element can contain one or more of the following form elYo

Objective:

The objective of this lab exercise is to introduce HTML Forms.

This lab maps to CLO#$2$

Procedure:

Go to the w$3$schools, HTML tutorial and do the following tutorials related to the HTML forms:

HTML Forms

HTML Forms

HTML Form Attributes

HTML Form Elements

HTML Input Types

HTML Input Attributes

HTML Input Form Attributes

Also, go through the following tutorials on the same page:

HTML Classes

HTML Id

HTML Iframes

HTML JavaScript

HTML File Paths

HTML Head

You may also use the uploaded presentation on HTML Forms.

The HTML