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<FORM action=NEED_TO_INPUT.php method=post>
<body style ="background: url(https://static01.nyt.com/images/2020/03/10/us/how-coronavirus-infects-a-cell-promo-1583866148761/how-coronavirus-infects-a-cell-promo-1583866148761-videoSixteenByNineJumbo1600-v3.jpg)">
<main class="form">
<h1 id="title">Health Survey </h1>
<p>Do you know the symptoms of COVID-19, the disease caused by the new coronavirus? <a href="https://www.hopkinsmedicine.org/profiles/results/directory/profile/0009313/lisa-maragakis">Lisa Maragakis, M.D., M.P.H.</a>, senior director of infection prevention, provides an update.</p>
<h2>What are symptoms of coronavirus (COVID-19)?</h2>
<p>The most common symptoms in humans include:</p>
<ul>
<li>Cough</li>
<li>Fever </li>
<li>Shortness of breath</li>
<li>Muscle aches</li>
<li>Sore throat</li>
<li>Unexplained loss of taste or smell</li>
<li>Diarrhea</li>
<li>Headache</li>
</ul>
<h2>Please fill out this health survey for your own good</h2>
<form id="survey-form" action="#">
<fieldset>
<legend>Your Details</legend>
<label id ="name-label" for="name">Name:
<input type="text" placeholder="Enter Your Name" id ="name" name="name" required>
</label><br/><br/>
<label id ="email-label" for ="email">Email:
<input type ="email" placeholder="Enter Your Email" id="email" name="email" required>
</label><br/><br/>
<label id ="number-label" for="Age">Age:
<input type="number" name="Age" id="number" min="1" max="110" class="age" placeholder="Enter Age">
</label><br/>
<p>
<label for ="comments">Any commnets?
<textarea name="comments">
</textarea>
</label></div><br/><br/>
<label for="reset_form">
<input type="reset" name="rest_form"></label>
<label for="submit">
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<a href=index.html>Home Page</a>
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