<%@ page language="java" contentType="text/html; charset=ISO-8859-1"
    pageEncoding="ISO-8859-1"%>
<!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=ISO-8859-1">
<title>Insert title here</title>
</head>
<body>
PATIENT ID<input type="text" name="t1" maxlength=10 size=20><BR>
PATIENT NAME<input type="text" name="t1" maxlength=10 size=20><BR>
PATIENT DEPARTMENT<input type="text" name="t1" maxlength=10 size=20><BR>
CONTACT NO<input type="text" name="t1" maxlength=10 size=20><BR>
GENDER<SELECT>
<option>MALE 
<OPTION> FEMALE
</SELECT><BR>
</body>
</html>