<body bgcolor="#FFFFFF">
<form name="OrderForm" action="Show_Orderpage_Post.php"
method="post">
<p>Name:
<input type="text" name="Name" size="40">
</p>
<p>Address:<br>
<textarea name="Address" cols="33" rows="6"
wrap="PHYSICAL"></textarea>
</p>
<p>Spices:
<select name="Spices[]" size="1" multiple>
<option selected>Cumin</option>
<option>Cinnamon</option>
<option>Nutmeg</option>
<option>Cloves</option>
<option>Pepper</option>
</select>
(12 oz.)</p>
<p>How do you want to pay? <br>
<input type="radio" name="Pay_when" value="Pay
now" checked> Pay now <br>
<input type="radio" name="Pay_when" value="Pay
on delivery"> Pay on delivery</p>
<p>Mode of payment:<br>
<input type="radio" name="Pay_mode" value="AMEX">
AMEX<br>
<input type="radio" name="Pay_mode" value="Master
Card"> Master Card<br>
<input type="radio" name="Pay_mode" value="VISA">
VISA</p>
<p>Which of the outlets have you visited?<br>
<input type="checkbox" name="Outlets[]" value="Shopper's
Paradise"> Shopper's Paradise<br>
<input type="checkbox" name="Outlets[]" value="Port
Plaza"> Port Plaza<br>
<input type="checkbox" name="Outlets[]" value="Stop
'n' Shop"> Stop 'n' Shop</p>
<p>
<input type="submit" name="Submit" value="Order
now!">
<input type="reset" name="Reset" value="Clear form">
</p>
</form>
</body>
</html>