<!DOCTYPE html> <html> <head> <meta charset="utf-8"> <meta name="viewport" content="width=device-width"> <title>replit</title> <link href="style.css" rel="stylesheet" type="text/css" /> </head> <body> <h1>Schedule a Visit</h1> <form> <label>Name:</label> <input type="text" id="name"> <label>Email:</label> <input type="email" id="email"> <label>Date:</label> <input type="date" id="date"> <label>Time:</label> <select id="time"> <option value="10:00">10:00 AM</option> <option value="11:00">11:00 AM</option> <option value="12:00">12:00 PM</option> <option value="13:00">1:00 PM</option> <option value="14:00">2:00 PM</option> <option value="15:00">3:00 PM</option> <option value="16:00">4:00 PM</option> <option value="17:00">5:00 PM</option> </select> <input type="submit" value="Schedule Visit"> </form> </body> </html>