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<html>

<head>
<title>Entry Data Mahasiswa</title>
<link href="style.css" rel="stylesheet" type="text/css" media="screen" />
</head>
<body>
<br><br>
<form action="simpan.php" method="post" enctype="multipart/form-data"
name="form_data">
<table bgcolor="#ffffff" width="500" border="0" align="center" cellspacing="1">
<tr>
<td height="40" align="center" bgcolor="#0099FF">
<strong><font color="#ffffff">ENTRY DATA MAHASIWA</font></strong>
</td>
</tr>
<tr>
<td bgcolor="#FFFFFF">
<table width="500" border="0" align="center" cellpadding="5">
<tr>
<td width="113">NIM</td>
<td width="11">:</td>
<td width="237">
<input name="nim" type="text" id="nim" size="12" maxlength="12">
</td>
</tr>
<tr>
<td>Nama</td>
<td>:</td>
<td>
<input name="nama" type="text" id="nama" size="30" maxlength="30">
</td>
</tr>
<tr>
<td>Tanggal Lahir</td>
<td>:</td>
<td><select name="tanggal" size="1" id="tanggal">
<?php
for($i=1; $i<=31; $i++){
echo "<option value=".$i.">".$i."</option>";
}
?>
</select>
<select name="bulan" size="1" id="bulan">
<?php
$bulan=array("","Januari",
"Februari",
"Maret",
"April",
"Mei",

"Juni",
"Juli",
"Agustus",
"September",
"Oktober",
"November",
"Desember");
for($i=1; $i<=12; $i++){
echo "<option value=".$i.">".$bulan[$i]."</option>";
}
?>
</select>
<select name="tahun" size="1" id="tahun">
<?php
for($i=1985; $i<=2013; $i++){
echo "<option value=".$i.">".$i."</option>";
}
?>
</select>
</td>
</tr>
<tr>
<td>Jenis Kelamin</td>
<td>:</td>
<td>
<input name="jenis_kelamin" type="radio" value="Laki-laki" checked>
Laki-laki &nbsp;&nbsp;
<input name="jenis_kelamin" type="radio" value="Perempuan">Perempuan
</td>
</tr>
<tr>
<td>Alamat</td>
<td>:</td>
<td>
<textarea name="alamat" cols="30" rows="5" id="alamat"></textarea>
</td>
</tr>
<tr>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td align="left">
<input name="simpan" type="submit" id="simpan" value="Simpan">
<input name="ulang" type="reset" id="ulang" value="Ulangi">
<input name="batal" type="button" id="batal" value="Batal"
onClick="javascript:history.back()">
</td>
</tr>
</body>

</html>