| nama | : | ||
| Alamat | : | ||
| TTL | : | ||
| Kelamin | : | Laki-LakiPerempuan | |
| Agama | : | ||
| Hobi | : | OlahragaBelajarKomputerMusikLain-Lain | |
| Motto | : | ||
<html>
<head><title>Biodata Pribadi</title></head>
<body>
<table border="1">
<tr>
<td>nama</td>
<td>:</td>
<td><input type="text" size="20" /></td>
<td></td>
</tr>
<tr>
<td>Alamat</td>
<td>:</td>
<td colspan="2"><input type="text" size="40" /></td>
</tr>
<tr>
<td>TTL</td>
<td>:</td>
<td><input type="text" size="20" /><select>
<option>-select date-</option>
<option>01</option>
<option>02</option>
<option>03</option>
<option>04</option>
<option>05</option>
<option>06</option>
<option>07</option>
<option>08</option>
<option>09</option>
<option>10</option>
</select>
<select>
<option>-select month-</option>
<option>january</option>
<option>february</option>
<option>March</option>
<option>April</option>
<option>may</option>
<option>June</option>
<option>July</option>
<option>August</option>
<option>September</option>
<option>October</option>
<option>November</option>
<option>December</option>
</select>
<select>
<option>-select year-</option>
<option>2000</option>
<option>1999</option>
<option>1998</option>
<option>1997</option>
<option>1996</option>
<option>1995</option>
<option>1994</option>
<option>1993</option>
<option>1992</option>
<option>1991</option>
<option>1990</option>
</select></td>
</tr>
<tr>
<td>Kelamin</td>
<td>:</td>
<td><input type="radio" />Laki-Laki<input type="radio" />Perempuan</td>
</tr>
<tr>
<td>Agama</td>
<td>:</td>
<td><select>
<option>-select religion-</option>
<option>Islam</option>
<option>Khatolik</option>
<option>Protestan</option>
<option>Budha</option>
<option>Hindu</option>
</select></td>
</tr>
<tr>
<td>Hobi</td>
<td>:</td>
<td><input type="checkbox">Olahraga<input type="checkbox">Belajar<input type="checkbox">Komputer<input type="checkbox">Musik<input type="checkbox">Lain-Lain</td>
</tr>
<tr>
<td>Motto</td>
<td>:</td>
<td><textarea cols="30" rows="4"></textarea></td>
</tr>
<tr>
<td></td>
<td></td>
<td><input type="submit" value="Submit"></td>
</tr>
</table>
