CS202 Assignment 1 Solution Spring 2021
Solution
CODE
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<title>CS202 Assignment 1 Solution Spring 2021</title>
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<body style="background-color: #9cfc9b;">
<h1 style="text-align:center; color:black;"><b>Hospital Survay
Form</b></h1>
Patient's First Name: <input type="text" style="margin-Left:6; width: 20;" >
Patient Second Name
<input type="text" style="width: 20;"><br><br>
Patient's Father / Husband Name: <input type="text" style="width: 20%; margin-Left:
5%;"><br><br>
Permanent Address: <input type="text" style="margin-Left:15%; width: 35 %;height:
30px;"><br> <br>
Gender:<input type="radio" style="margin-Left:12%;"> Male <br>
<input type="radio" style="margin-Left: 15.8%;"> Female <br><br>
Patient's Age: <input type="text" style="margin-Left:9% ;width: 20%;"><br><br>
Mobile No: <input type="text" style="margin-Left:10% ;width: 20%;"><br><br>
Have you been diagnosed as COVID-19 Postive Patient?:<input type="radio" style="marginLeft: 2%;">Yes<input type="radio"style="margin-Left: 15 ;">N0<br><br >
<h3 style="coLor:black;">Please select suitable option from Given
below</h3><br>
<input type="checkbox"style="margin-Left: 20%;">I am Still having COVID-19 symptoms.<br>
<input type="checkbox"style="margin-Left: 20%;">I have no other symptoms but have a dry
cough.<br>
<input type="checkbox"style="margin-Left: 20%;">I just feel very tired.<br>
<input type="checkbox"style="margin-Left: 20%;">I am having a trouble taking deep breeths.<br>
<input type="checkbox"style="margin-Left: 20%;">I am feeling like I am having tight band
wrapped around my chest. <br>
<input type="checkbox"style="margin-Left: 20%;">I have having Loss of smell and taste. <br>
<input type="text" style="margin-Left: 20%;"> (Mention Other feelings(s))
<h3 style="color:black;">Please Select Suitable Option from Below Given Options:</h3>
<br>
<input type="checkbox"style="margin-Left: 20%;">I am not having COVID-19 symptoms. <br>
<input type="checkbox"style="margin-Left: 20%;">I am having headache all the time..<br>
<input type="checkbox"style="margin-Left: 20%;">I have developed muscles aches.<br>
<input type="checkbox"style="margin-Left: 20%;">I am having fever inspite of havig COVID-19
negtive test result.<br>
<input type="text" style="margin-Left:20%;">Mention Other feelings<br><br>
<button style="margin-Left: 20; color: darkgreen;">Submit</button>
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</body>
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Result:
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