Incident Report Form

by twong17

HTML

<html?>
  <head>
    <title> title placeholder </title>
  </head>
  <body>
    <h1>Incident Report Form</h1>
    <hr>
    <h2>
    Client Information:
    </h2>
    Last Name: <br>
    <input type = "text" name = "lname">
    <br><br>
    First Name: <br>
    <input type = "text" name = "fname">
    <br><br>
    Job Position: <br>
    <input type = "text" name = "job">
    <br><br>
    Email Address: <br>
    <input type = "text" name = "email">
    <br><br>
    IP Address: <br>
    <input type = "text" name = "IPAddress">
    <hr>
  
    <h2>
      Incident
    </h2>
    Incident Number: <br>
    <input type = "text" name = "incidentNum">
    <br>
    <br>
    Incident State: <br>
     <select>
      <option value="">-Select-</option>
      <option value="incidentState">Open</option>
      <option value="incidentState">Closed</option>
      <option value="incidentState">Stalled</option>
    </select>
    <br> <br>
    Type of incident: <br> 
    <select>
      <option value="">-Select-</option>
      <option value="incidentType">Email Based Abuse</option>
      <option value="incidentType">Copyright Infringement Reports</option>
    </select>
    
  <br>  <br>
    Comment: <br>
      <textarea rows="7" cols="44">Explanation.</textarea>
  </body>
</html?>