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index4.html
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index4.html
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<!DOCTYPE html>
<html lang="en-in">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<link rel="icon" type="image/x-icon" href="logo.png">
<link rel="stylesheet" href="style.css">
<title>911 Dispatch</title>
</head>
<body>
<h1>In Case Of Pregnancy: -</h1>
<div class="container">
<form action="index.html">
<div class="row">
<div class="col-25">
<label for="miscarriage-stillbirth">Apparent MISCARRIAGE or STILLBIRTH: </label>
</div>
<div class="col-75">
<select id="options" name="options" required>
<option value="no">No</option>
<option value="miscarriage">MISCARRIAGE (fetus or tissue)</option>
<option value="thereatened-miscarriage">Threatened MISCARRIAGE (contractions)</option>
<option value="stillbirth">STILLBIRTH (non-viable baby born)</option>
</select><br>
</div>
</div>
<div class="row">
<div class="col-25">
<label for="days-of-pregnancy">How many <b>weeks</b> (or <b>months</b>) pregnant is she? </b>: </label>
</div>
<div class="col-75">
<select id="options" name="options" required>
<option value="3rdtrimester">24+ wks (6-9 mos) 3rd TRIMESTER</option>
<option value="2sttrimester">13-23 wks (4-5 mos) 2nd TRIMESTER</option>
<option value="1sttrimester">0-12 wks (0-3 mos) 1st TRIMESTER</option>
<option value="knows">Knows due date</option>
<option value="unknown">Unknown</option>
</select><br>
</div>
</div>
<div class="row">
<div class="col-25">
<label for="visible-baby-part">Can you <b>see</b> any part of the <b>baby</b> now?: </label>
</div>
<div class="col-75">
<select id="options" name="options" required>
<option value="no">No</option>
<option value="complete-out">Baby completely out</option>
<option value="hand">Head visible (crowning)</option>
<option value="head">Head out</option>
<option value="umbilical-cord">Umbilical cord</option>
<option value="hands">Hands</option>
<option value="feet">Feet</option>
<option value="buttocks">Buttocks</option>
<option value="something">Something out (not sure what)</option>
<option value="cant-check">Can't check</option>
</select><br>
</div>
</div>
<div class="row">
<div class="col-25">
<label for="multiple-birth"><b>Caller mention of a multiple birth: </b></label>
</div>
<div class="col-75">
<select id="options" name="options" required>
<option value="no">No</option>
<option value="yes">Yes</option>
</select><br>
</div>
</div>
<input type="submit" value="Submit">
</form><br><br>
</div>
<div class="container">
<form>
<div class="row">
<div class="col-25">
<label for="baby-crying">Is the baby <b>crying</b> or <b>breathing</b>: </b></label>
</div>
<div class="col-75">
<select id="options" name="options" required>
<option value="yes">Yes</option>
<option value="no">No</option>
</select><br>
</div>
</div>
<input type="submit" value="Submit">
</form>
</div>
</body>
</html>