Preview:
<!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>
downloadDownload PNG downloadDownload JPEG downloadDownload SVG

Tip: You can change the style, width & colours of the snippet with the inspect tool before clicking Download!

Click to optimize width for Twitter