t/html/fillinform/fillinform.initial

   1   <div>
   2     <h1>Dialer</h1>
   3
   4     <form id="appform" method="post" name="appform">
   5       <div id="city_div">
   6         City: <input type="text" name="city">
   7       </div>
   8
   9       <div id="state_div">
  10         State: <input type="text" name="state">
  11       </div>
  12
  13       <div id="company_div">
  14         Company: <input type="text" name="company">
  15       </div>
  16
  17       <div id="data_source_div">
  18         Data Source: <input type="text" name="data_source">
  19       </div><input type="submit" value="locate records">
  20     </form>
  21   </div>