<form>
First name: <input type="text" name="firstname" /><br />
Last name: <input type="text" name="lastname" /><br />
Gender: <br />
<input type="radio" name="gender" value="male" /> Male <br />
<input type="radio" name="gender" value="female" /> Female <br />
Civil Status: <br />
<input type="checkbox" name="status" value="Single" /> Single<br />
<input type="checkbox" name="status" value="Married" /> Married<br />
<input type="checkbox" name="status" value="Widow" /> Widow<br /><br /><br />
<input type="reset" name="Reset" value="Reset" />
<input type="button" name="Submit" value="Submit" />
</form>
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