File: fillinform.html

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libhtml-element-library-perl 5.220000-1
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<div>
	<h1>Dialer</h1>
	<form id="appform" method="post" name="appform">
		<div id="city_div">        City:        <input type="text" name="city"/> </div>
		<div id="state_div">       State:       <input type="text" name="state"/> </div>
		<div id="company_div">     Company:     <input type="text" name="company"/> </div>
		<div id="data_source_div"> Data Source: <input type="text" name="data_source"/> </div>
		<input type="submit" value="locate records"/>
	</form>
</div>