<%@ page language="java" contentType="text/html; charset=ISO-8859-1"
    pageEncoding="ISO-8859-1"%>
<!DOCTYPE html>
<html>
<head>
<meta charset="ISO-8859-1">
<title>Artifacts | Payment Gateway</title>
<link href="stylep.css" rel="stylesheet">
   <link rel="stylesheet" href="https://stackpath.bootstrapcdn.com/font-awesome/4.7.0/css/font-awesome.min.css">

</head>
<body>

			<div class="wrapper">
            
        <img src="images/pay.gif" class="pay">
        <h2>Payment Form</h2>
            <form method="POST"></form>
                <h4>Account</h4>
                <div class="input-group">
                <div class="input-box">
                    <input type="text" placeholder="Full Name" required class="name">
                    <i class="fa fa-user icon"></i>
                    </div>
                    <div class="input-box">
                     <input type= "text" placeholder="Account Holder Name" class="name">
                        <i class ="fa fa-user icon"></i>
                   
                    </div>
            </div>
            <div class="input-group">
            <div class="input-box">
              <input type="email" placeholder="Email Address" required class="name">  
                <i class="fa fa-envelope icon"></i>
            </div>
        </div>
            <div class="input-group">
            <div class="input-box">
                <h4>Date Of Birth</h4>
              <input type="text" placeholder="DD" required class=dob>  
                <input type="text" placeholder="MM" required class=dob>  
                <input type="text" placeholder="YYY" required class=dob>  
            </div>
                <div class="input-box">
                <h4>Gender</h4>
                <input type="radio" id="b1" name="gender" checked class="radio">
                    <label for="b1">Male</label>
                    <input type="radio" id="b2" name="gender" checked class="radio">
                    <label for="b2">Female</label>
                </div>
        </div>
            <div class="input-group">
                <div class="input-box">
                    <h4>Payment Details</h4>
                        <input type="radio" name="pay" id="bc1" checked class="radio">
                    <label for="bc1"><span><i class="fa fa-cc-visa"></i> Credit Card</span></label>
                     <input type="radio" name="pay" id="bc2" checked class="radio">
                    <label for="bc2"><span><i class="fa fa-money"></i> Paytm</span></label>
                
                </div>
            
            </div>
            <div class="input-group"> 
                <div class="input-box">
                        <input type="tel" placeholder="Card Number"  required class="name">
                    
                
                </div>
            </div>
            
            <div class="input-group"> 
                <div class="input-box">
                        <input type="tel" placeholder="Card CVC"  required class="name">
                    <i class="fa fa-user icon"></i>
                
                </div>
                <div class="input-box"> 
                <select>
                    <option>01 June</option>
                    <option>02 June</option>
                    <option>03 June</option>
                    </select>
                    <select> 
                    <option>2021</option>
                    <option>2022</option>
                    <option>2023</option>
                    </select>
                </div>
            </div>
            <a href="final.jsp">
               
                
                        <button type="submit">PAY NOW</button>
                
                
            </a>
             
        </div>
        
        

</body>
</html>