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<!DOCTYPE html>
<html>
<head>
<title>payment Form</title>
</head>
<body>
<h1>
Payment Form
</h1>
<hr>
<h2>
User Details
</h2>
<form action="php">
<p> Name : <input type="text" name=" Name"placeholder=" Enter your name" required >
</p>
<fieldset>
<legend>
Gender
</legend>
<p>
Male <input type ="radio" Name="Gender" Id="Male" required> Female <input type ="radio" Name="Gender" Id="Female" required>
</p>
</fieldset>
<p>
Address : <textarea type="text" Name="Address" id="address" cols="40px" rows="7px" required ></textarea>
</p>
<p>
Email : <input type="email" name="Email" id="email" required>
</p>
<p>
Pincode: <input type="number" name="pincode" id="pincode" required>
</p>
<hr>
<h2>
Payment Details
</h2>
<p>
<select Name="CardType" id=" card type" required>
<option value="">>--Select a card type--<</option>
<option value="master card">Master card</option>
<option value="visa card">Visa card</option>
<option value="Debit card">Debit card</option>
</select>
</p>
<p>
Card number:<input type="number" name="cardnumber" id=" card number" required>
</p>
<p>
Expiration Date: <input type ="date" name ="Expiry Date" id="expiry date" required>
</p>
<p>
CVV: <input type="number" name="cvv" id="cvv" required>
</p>
<input type="submit" value=" Pay Now">
</form>
<hr>
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</body>
</html>
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