<table width="90%" border="0" align="center" >
<tr>
<td width="25%">Nama</td>
<td width="2%">:</td>
<td width="73%"><input name="txtnama" type="text" id="txtnama"
size="50"bgcolor="red"></td>
</tr>
<tr>
<td>Tempat Tanggal Lahir </td>
<td>:</td>
<td><input name="tempat" type="text" id="tempat" size="20">
/
<input name="textfield" type="text" size="5">
-
<select name="sBulan" id="sBulan" >
<option value="januari" selected>Januari</option>
<option value="pebruari">Pebruari</option>
<option value="maret">Maret</option>
<option value="april">April</option>
<option value="mei">Mei</option>
<option value="juni">Juni</option>
<option value="juli">Juli</option>
<option value="agustus">Agustus</option>
<option value="september">September</option>
<option value="oktober">Oktober</option>
<option value="nopember">Nopember</option>
<option value="desember">Desember</option>
</select>
-
<select name="sTahun" id="sTahun">
<option value="1980" selected>1980</option>
<option value="1981">1981</option>
<option value="1982">1982</option>
<option value="1983">1983</option>
<option value="1984">1984</option>
<option value="1985">1985</option>
<option value="1986">1986</option>
<option value="1987">1987</option>
<option value="1988">1988</option>
<option value="1989">1989</option>
<option value="1990">1990</option>
<option value="1991">1991</option>
<option value="1992">1992</option>
<option value="1993">1993</option>
<option value="1994">1994</option>
<option value="1995">1995</option>
</select></td>
<tr>
<td width="25%">Email</td>
<td width="2%">:</td>
<td width="73%"><input name="txtnama" type="text" id="txtnama" size="50"></td>
</tr>
</tr>
<tr>
<td>Komentar</td>
<td>:</td>
<td><textarea name="areaKomentar" cols="50" rows="3" id="areaKomentar"></textarea></td>
</tr>
<tr>
<td> </td>
<td> </td>
<td><input type="submit" name="Submit" value="Send">
<input type="reset" name="Reset" value="Reset"></td>
</tr>
</table>
simpan dalam format .html
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