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registration1.html
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<!DOCTYPE html>
<html lang="en">
<head>
<title> Life insurance ICICI - Perosnal Details</title>
<link rel="icon" type="image/png" href="img.png">
<link rel="stylesheet" href="registration1.css">
</head>
<body>
<div class="main">
<div class="navbar">
<h2 class="logo">ICICI Life<br> Insurance </h2>
<div class="container">
<!--<h1 align="left">Register</h1>-->
<p>Nominee Details:</p>
<br>
<label for="Name" class="standard-label">
Name of the Nominee: <span class="required"></span>
<input class="standard-input" Name="Name" id="Name" type="text" placeholder="Full Name Here" required>
</label>
<br>
<label for="phone-number" class="standard-label">
Phone Number: <span class="required"></span>
<input class="standard-input" type="tel" id="phone" name="phone" pattern='^\+?\d{91}' placeholder="Personal Phone" required>
</label>
<br>
<label for="Birthday" class="standard-label">
Date of Birth: <span class="required"></span>
<input class="standard-input" Name="Name" id="Name" type="date" placeholder="Full Name Here" required>
</label>
<br>
<br>
<p>Nominee Address:</p>
<br>
<label for="Name" class="standard-label">
<label for="email-address" class="standard-label">
Permenant Address:<span class="required"></span>
<input class="standard-input" id="email-address" type="email" placeholder="" required>
</label>
<br>
<label for="phone-number" class="standard-label">
City: <span class="required"></span>
<input class="standard-input" type="tel" id="phone" name="phone" placeholder="" required>
</label>
<br>
<label for="phone-number" class="standard-label">
State: <span class="required"></span>
<input class="standard-input" type="tel" id="phone" name="phone" placeholder="" required>
</label>
<br>
<label for="phone-number" class="standard-label">
Pin Code: <span class="required"></span>
<input class="standard-input" type="tel" id="phone" name="phone" placeholder="" required>
</label>
<br><br><br><br><br>
<br>
</div>
<div class="container1">
<br>
<p id="second">Personal details:</p>
<br>
<label for="marital" class="standard-label1">
Marital Status:<span class="required"></span>
</label>
<select name="marital">
<option value="Single">Single</option>
<option value="Married">Married</option>
<option value="Divorced">Divorced</option>
<option value="Widow">Widow</option>
</select>
<br>
<br>
<label for="Name" class="standard-label1">
Aadhar Number:<span class="required"></span>
<input class="standard-input" Name="Name" id="Name" type="aadhar" placeholder="" required>
</label>
<br>
<br>
<label for="pancard" class="standard-label1">
Pancard Number: <span class="required"></span>
<input class="standard-input" type="pancard" id="phone" name="phone" placeholder="" required>
</label>
<br>
<br>
<label for="occu" class="standard-label1">
Occupation: <span class="required"></span>
<input class="standard-input" type="occu" id="phone" name="phone"placeholder="" required>
</label>
<br>
<br>
<label for="income" class="standard-label1">
Annual Income: <span class="required"></span>
<input class="standard-input" type="income" id="phone" name="phone" placeholder="eg.5.9" required>
</label>
<br>
<br>
<label for="phone-number" class="standard-label1">
Height,Weight: <span class="required"></span>
<input class="standard-input" type="income" id="phone" name="phone" placeholder="eg. 5'10,60" required>
</label>
<br>
<br>
<label for="smoke" class="standard-label1">
Person with disability: <span class="required"></span>
<input class="standard-input" type="radio" value="Yes" name="disability" placeholder="" required> Yes
<input class="standard-input" type="radio" value="No" name="disability" placeholder="" required> No
</label>
<br>
<br>
<label for="smoke" class="standard-label1">
Do you smoke or chew tobacco?: <span class="required"></span>
<input class="standard-input" type="radio" value="Yes" name="smoke" placeholder="" required> Yes
<input class="standard-input" type="radio" value="No" name="smoke" placeholder="" required> No
</label>
<br>
<br>
<label for="health" class="standard-label1">
Describe any health issue: <span class=""></span> <br>
<p id="third"><textarea rows="3" col="10" name="description" spell="false">If none, leave blank</textarea></p>
</label>
<br>
<p id="fourth"> <input type="checkbox" name="term" value="Bike"> I agree to the terms and conditions as set out by the user agreement and allow the bank to contact you via    Call for further information about term plan</p>
<button class="btnn"><a href="submit.html">Submit</a></button>
</div>
</div>
</div>
<script src="https://unpkg.com/ionicons@5.4.0/dist/ionicons.js"></script>
</body>
</html>