23.26
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<html>
<head>
<title>Entry Data KTP</title>
</head>
<body>
<H1><center>Program Entry Data KTP</center> </H1>
<H2><center>Provinsi JAWA TENGAH</center> </H2>
<form method=post action="tampilktp.php">
<center><table widht="41%" border="0">
<tr>
<td> NIK </td>
<td><input type="text" name="nik"></td>
</tr>
<tr>
<td>Nama Lengkap</td>
<td><input type="text" name="nama"></td>
</tr>
<tr>
<td> Tempat/Tgl Lahir</td>
<td> <input type="text" name="tempat"></td>
<td><select name="tgl">
<?
for($tgl=1;$tgl<=31;$tgl++){
print"<option value=$tgl</option>";
}
?>
</select>
<select name="bln">
<?
$bulan=array("Januari","Februari","Maret","April","Mei","Juni","Juli","Agustus","September","Oktober","November","Desember");
$jlh_bln=count($bulan);
for($c=0;$c<$jlh_bln;$c+=1){
print"<option value=$bulan[$c]> $bulan[$c]</option>";
}
?>
</select>
<select name="thn">
<?
for($thn=1990;$thn<=2012;$thn++){
print"<option value=$thn>$thn</option>";
}
?>
</select>
</td>
</tr>
<tr>
<td>Jenis Kelamin</td>
<td><input name="gender" type="radio" value="L"/> Laki-laki<br>
<input name="gender" type="radio" value="P"/>Perempuan</td>
<td>Gol.Darah
<Select name="darah">
<option value="a">A</option>
<option value="b">B</option>
<option value="ab">AB</option>
<option value="o">O</option>
</select></td>
</tr>
<tr>
<td>Alamat</td>
<td><textarea name="alm" row 3 cols="16"> </textarea></td>
</tr>
<tr>
<td>RT/RW</td>
<td><select name="rt">
<?
for($rt=1;$rt<=15;$rt++){
print"<option value=$rt</option>";
}
?>
</select>
<select name="rw">
<?
$erwe=array("I","II","III","IV","V","VI","VII","VIII","IX","X","XI","XII","XIII");
$jum_rw=count($erwe);
for($c=0;$c<$jum_rw;$c+=1){
print"<option value=$erwe[$c] </option>";
}
?>
</select>
</td>
</tr>
<tr>
<td> Desa/Kel.</td>
<td><input type="text" name="kel"></td>
</tr>
<tr>
<td>Kecamatan</td>
<td><input type="text" name="camat"></td>
</tr>
<tr>
<td>Agama</td>
<td><select name="agama">
<option value="islam">ISLAM</option>
<option value="kristen">KRISTEN</option>
<option value="khatolik">KHATOLIK</option>
<option value="budha">BUDHA</option>
</select></td>
<td>Status :
<select name="status">
<option value="kawin">KAWIN</option>
<option value="kawin">TIDAK KAWIN</option>
</select>
</td>
</tr>
<tr>
<td>Pekerjaan</td>
<td><input type="text" name="kerja"></td>
</tr>
<tr>
<td>kewarganegaraan</td>
<td><select name="warga">
<option value="wni">WNI</option>
<option value="wna">WNA</option>
</select>
</td>
</tr>
</center></table>
</form><br>
<center><input type=submit value=cetak><input type=reset value=Batal> </center>
</body>
</html>
DATA di tampilkan pada :
tampilktp.php
======================
<html>
<head>
<title> Entry Data KTP</title>
</head>
<body>
<p><h1>Data Warga Negara RI</h1></p>
<?
$nik=$_POST['nik'];
$nama=$_POST['nama'];
$tempat=$_POST['tempat'];
$jenkel=$_POST['gender'];
$gol=$_POST['darah'];
$alm=$_POST['alm'];
$rt=$_POST['rt'];
$rw=$_POST['rw'];
$kel=$_POST['kel'];
$camat=$_POST['camat'];
$agama=$_POST['agama'];
$status=$_POST['status'];
$kerja=$_POST['kerja'];
$warga=$_POST['warga'];
$tgl=$_POST['tgl'];
$bln=$_POST['bulan'];
$thn=$_POST['thn'];
$bln=$_POST['bln'];
$thn=$_POST['thn'];
$tglsek=date("Y");
$tgllama=$tglsek+5;
print "NIK :$nik<br>";
print "Nama Lengkap :$nama<br>";
print "Tempat/Tgl Lahir:$tempat/$thn-$bln-$tgl<br>";
print "<br>Jenis Kelamin:$gender<br>";
print "Gol.Darah:$gol<br>";
print "Alamat :$alm ";
print "RT $rt <br>";
print " RW :$rw<br>";
print "<br>Desa / Kelurahan :$kel<br>";
print "Kecamatan :$camat<br>";
print "Agama :$agama<br>";
print "Status :$status<br>";
print "Pekerjaan :$kerja<br>";
print "Kewarganegaraan :$warga<br>";
print "Masa Berlaku :$tgl - $bln - $tgllama<br>";
?>
</body>
</html>
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