<!doctype html>
<html>
<head>
<title>信息采集</title>
<meta charset="utf-8">
<link rel="icon" href="./favicon.ico">
</head>
<body>
<center>
<table border="1" bgcolor="#FBEBBA" cellspacing="0" cellpadding="0">
<form action="" method="get">
<tr>
<td colspan="4" width="800" height="50" align="center"><font size="5"><b>信息采集</b></font></td>
</tr>
<tr>
<td width="80" height="50">姓名：</td>
<td width="240">
<input type="text" name="" placeholder="请输入姓名" autofocus required>
</td>
<td width="150">性别：</td>
<td>
<label><input type="radio" name="sex[]"/>男</label>
<label><input type="radio" name="sex[]" />女</label>
</td>
</tr>
<tr>
<td height="50">地区：</td>
<td>
<select name="diqu">
<option>---请选择----</option>
<option>北京</option>
<option>上海</option>
<option>广州</option>
<option>杭州</option>
<option>深圳</option>
<option>大连</option>
<option>南京</option>
<option>湖南</option>
</select>
</td>
<td>联系电话：</td>
<td>
<input type="tel" name="">
</td>
</tr>
<tr>
<td height="50">爱好:</td>
<td colspan="3">
<input type="checkbox" name="hoody[]" checked>绘画
<input type="checkbox" name="hoody[]">读书
<input type="checkbox" name="hoody[]" checked>音乐
<input type="checkbox" name="hoody[]">跳舞
<input type="checkbox" name="hoody[]" checked>运动
</td>
</tr>
<tr>
<td height="150">备注：</td>
<td colspan="3">
<textarea name="bz" cols="40" rows="8"></textarea>
</td>
</tr>
<tr bgcolor="#CF9563">
<td height="50"></td>
<td>
<input type="submit" value="提交">
</td>
<td>
<input type="reset" value="重置">
</td>
<td>
<b>信息采集时间：</b><input type="datetime-local" name="time" value="">
</td>
</tr>
</from>
</table>
</center>
</body>
</html>
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