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  • Tugas 5-10122117-Randi Zakaria Putra

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    hamid misbahudin
    7 views4 pages
    The document is a source code for an HTML form to collect personal data for an electronic ID card (e-KTP). The form includes fields for collecting information such as name, date of birth, address, religion, citizenship status, and includes options to upload a photo. It contains input fields like text boxes, dropdown menus, radio buttons, and a file upload field to collect all necessary information.

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    Original Title

    TUGAS 5-10122117-RANDI ZAKARIA PUTRA

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    The document is a source code for an HTML form to collect personal data for an electronic ID card (e-KTP). The form includes fields for collecting information such as name, date of birth, address, religion, citizenship status, and includes options to upload a photo. It contains input fields like text boxes, dropdown menus, radio buttons, and a file upload field to collect all necessary information.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    7 views4 pages

    Tugas 5-10122117-Randi Zakaria Putra

    Uploaded by

    hamid misbahudin
    The document is a source code for an HTML form to collect personal data for an electronic ID card (e-KTP). The form includes fields for collecting information such as name, date of birth, address, religion, citizenship status, and includes options to upload a photo. It contains input fields like text boxes, dropdown menus, radio buttons, and a file upload field to collect all necessary information.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 4

    Tugas 5 Pemrograman Web 1

    Randi Zakaria Putra – 10122117


    IF-4
    Source Code :

    <html>
    <form action="test.php" methode="post">
    <head>
    <title>E-KTP</title>
    </head>
    <center>
    <h1>DATA DIRI E-KTP</h1>
    <hr>
    <table>
    <tr><td>NIK<td>:<input type="text" maxlength="16" placeholder="NIK">
    <tr><td>Nama<td>:<input type="text" placeholder="NAMA">
    <tr><td>Tempat/Tgl lahir<td>:<input type="text" placeholder="Tempat"
    name="Tempat">/<input type="date">
    <tr><td>Jenis Kelamin<td>:<input type="radio" name="jeniskelamin"
    value="Laki-Laki">Laki-Laki
    <input type="radio" name="jeniskelamin"
    value="perempuan">perempuan
    <tr><td>Gol.Darah<td>:
    <select name="Gol.Darah">
    <option>A</option>
    <option>AB</option>
    <option>B</option>
    <option>O</option>
    </select>
    <tr><td>Alamat<td>:<input type="text" placeholder="Alamat">
    <tr><td>RT/RW<td>:<input type="text" placeholder="000"
    size="3">/<input type="text" placeholder="000" size="3">
    <tr><td>Kel/Desa<td>:<input type="text"
    placeholder="Kelurahan">/<input type="text" placeholder="Desa">
    <tr><td>Agama<td>:
    <select name="Agama">
    <option>Islam</option>
    <option>Kristen Protestan</option>
    <option>Kristen Khatolik</option>
    <option>Hindu</option>
    <option>Budha</option>
    <option>Konghucu</option>
    <option>Lainnya</option>
    </select>
    <tr><td>Status Perkawinan<td>:<input type="radio" name="Status Perkawinan"
    value="Kawin">Kawin
    <input type="radio" name="Status Perkawinan" value="Belum
    Kawin">Belum Kawin
    <tr><td>Pekerjaan<td>:<input type="text" placeholder="Pekerjaan">
    <tr><td>Kewarganegaraan<td>:
    <select name="Kewarganegaraan">
    <option>WNI</option>
    <option>WNA</option>
    </select>
    <tr><td>Berlaku hingga<td>:SEUMUR HIDUP</tr></td>
    <tr><td>Masukkan Foto Anda<td>:<input type=file>
    </table>
    <hr>
    <input type="submit" value="Daftar">
    <input type="reset" value="Cancel">
    </html>
    Hasil :

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