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Name: resources/forms/form-a.html
1: | <input type=text name=name placeholder="Name des Versicherten" id="name" /> |
2: | <input type=text name=versnr placeholder="Versicherungsnummer" id="versnr" /> |
3: | <input type=text name=mail placeholder="E-mail Adresse" id="mail" /> |
4: | <input type=text name=garage placeholder="Garage" id="garage" /> |
5: | <input type=text name=schadenssumme placeholder="Schadenssumme" id="schadenssumme" /> |
6: | <p></p><button type=submit>absenden</button> |