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mn.html
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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<meta name="viewport" content=
"width=device-width, initial-scale=1.0">
<link rel="stylesheet" href="/Users/phq/Desktop/Mayank/my-express-server/styles.css">
<link rel="preconnect" href="https://fonts.googleapis.com">
<link rel="preconnect" href="https://fonts.gstatic.com" crossorigin>
<link href="https://fonts.googleapis.com/css2?family=Lora:wght@700&display=swap" rel="stylesheet">
<title>
Healthy-lyf </title>
</head>
<body>
<h1 class="Head">Personal Details</h1>
<h2 class="subhead">Fore better assistance please fill your information. Thank You!!</h2>
<!-- Create Form -->
<form id="form">
<div class="background">
<!-- Details -->
<div class="form-control">
<label for="name" id="label-name">
Name
</label>
<!-- Input Type Text -->
<input type="text"
id="name"
placeholder="Enter your name" />
</div>
<div class="form-control">
<label for="email" id="label-email">
Email
</label>
<!-- Input Type Email-->
<input type="email"
id="email"
placeholder="Enter your email" />
</div>
<div class="form-control">
<label for="age" id="label-age">
Age
</label>
<!-- Input Type Text -->
<input type="text"
id="age"
placeholder="Enter your age" />
</div>
<div class="form-control">
<label for="phone">Enter your phone number:</label>
<input type="tel" id="phone" name="phone" placeholder="Enter your Mobile no. ">
</div>
<div class="form-control">
<label for="role" id="label-role">
Which option best describes your health conditions as for now ?
</label>
<!-- Dropdown options -->
<select name="role" id="role">
<option value="Short">Short term illeness</option>
<option value="Long">Long term illeness</option>
<option value="other">Other</option>
</select>
</div>
<div class="form-control">
<label for="comment">
Please give us some brief idea about your health condition:)
</label>
<!-- multi-line text input control -->
<textarea name="comment" id="comment"
placeholder="Enter your comment here"></textarea>
</div>
<div class="form-control">
<label>
Would you like Havi to track you (just for health purposes)???
</label>
<!-- Input Type Radio Button -->
<label for="recommed-1">
<input type="radio"
id="recommed-1"
name="recommed">Yes</input>
</label>
<label for="recommed-2">
<input type="radio"
id="recommed-2"
name="recommed">No</input>
</label>
<label for="recommed-3">
<input type="radio"
id="recommed-3"
name="recommed">Maybe</input>
</label>
</div>
<div class="form-control">
<label for="comment">
Any comments or suggestions
</label>
<!-- multi-line text input control -->
<textarea name="comment" id="comment"
placeholder="Enter your comment here">
</textarea>
</div>
<!-- Multi-line Text Input Control -->
<button type="submit" value="submit">
Submit
</button>
</div>
</form>
<div id="googleMap" style="width:100%;height:400px;"></div>
<script>
function myMap() {
var mapProp= {
center:new google.maps.LatLng(51.508742,-0.120850),
zoom:5,
};
var map = new google.maps.Map(document.getElementById("googleMap"),mapProp);
}
</script>
<script src="https://maps.googleapis.com/maps/api/js?key=YOUR_KEY&callback=myMap"></script>
</body>
</html>