<html>
<body>
<form action="web" method="POST">
<p>
<label>Titulli</label>
<label>
<input type="radio" name="title" value="mr">
Z.
</label>
<label>
<input type="radio" name="title" value="ms">
Znjsh.
</label>
<label>
<input type="radio" name="title" value="miss">
Znj.
</label>
<hr>
<p>
<label>Emri</label>
<input type="text" value="vendos emrin">
</p>
<p>
<label>Mbiemri</label>
<input type="text" value="vendos mbiemrin">
</p>
<p>
<label>Email</label>
<input type="email" value="
[email protected]">
</p>
<p>
<label>Telefon</label>
<input type="tel" value="+355xxxxxxxxx">
</p>
<p>
<label>Passwordi</label>
<input type="password" value="Vendos_Password">
</p>
<p>
<label>Konfirmimi Passwordit</label>
<input type="password" value="password_konfirmim">
</p>
<p>
<label>Qyteti</label>
<select>
<option>Tirane</option>
<option>Durres</option>
<option>Lushnje</option>
<option>Shkoder</option>
<option>Gjirokaster</option>
<option>Korce</option>
<option>Fier</option>
<option>Kukes</option>
</select>
</p>
<p>
<label>
<input type="checkbox" value="terms">
Une i pranoj <a href="/terms">Kushtet dhe termat</a>
</label>
</p>
<p>
<button>
Regjistrohu
</button>
</p>
</p>
</form>
</body>
</html>