templates/insplan.html · Revamping-Health-Insurance-Using-Quantum-Cryptography-Based-Blockchain

<!DOCTYPE html>
<html>
<head>
  <meta charset="utf-8">
  <meta name="viewport" content="width=device-width, initial-scale=1">
  <title></title>
</head>
<style>
@import url('https://fonts.googleapis.com/css?family=Open+Sans:600');
body {
  align-items: center;
  background: #EEF5FD;
  color: #545556;
  display: flex;
  font-family: "Open Sans", sans-serif;
  font-size: 20px;
  height: 100vh;
  justify-content: center;
  margin: 0;
}
input[type=number],input[type=date],input[type=text] {
  width: 90%;
  padding: 12px 20px;
  margin: 8px 0;
  box-sizing: border-box;
  border: 2px solid rgb(19, 121, 161);
  border-radius: 4px;
  align-items: flex-start;
  align-items: center;
  left: 18px;
}


.containerOuter {
  background: white;
  border-radius: 8px;
  box-shadow: 2px 6px 20px 2px rgba(10,10,120,0.15);
}
.container {
  position: relative;
  margin: 20px;
  overflow: hidden;
  width: 500px;
  height: 750px;
}



.circle {
  border: 2px solid #545556;
  border-radius: 50%;
  cursor: pointer;
  height: 20px;
  
  transition: border-color 300ms;
  width: 20px;
}
.button {
  background-color: #4CAF50; /* Green */
  border-radius: 4px;
  border: none;
  color: white;
  text-align: center;
  text-decoration: none;
  display: inline-block;
  font-size: 16px;
  margin: 8px 2px;
  cursor: pointer;
  
}


.button2 {padding: 12px 28px;}



</style>
<body>
<br><br>
<form action ="/see_insurance_avail" method="POST">
 <div class="containerOuter">
  
  <div class="container">
  <input type="hidden"  name="key" value="d203fd7a157c4a69733a727ae66d431407cc1cca549fb3733a09f239217146ec"><br>
  <label>  Your ID</label>
  <br>
  <input type="number"  name="id"><br>
  <br>
  <label>Today's Date</label>
  <br>
  <input type="date"  name="date"><br>
  <br>
  
  <input type="radio" class="circle" name="plan" value="A"> PLAN A</input><br><br>
  <li>
    Basic fee : 5 ether 
  </li>
  <li>
    Premium : 10 ether
  </li>
  <li>
    Deductible : 20 ether 
  </li>
  <li>
    Coverage : 45 ether 
  </li>
  <li>
    Duration : 1 month
  </li>
  <br>
  <input type="radio" class="circle" name="plan" value="B"> PLAN B</input><br><br>
  <li>
    Basic fee : 7 ether 
  </li>
  <li>
    Premium : 20 ether
  </li>
  <li>
    Deductible : 15 ether 
  </li>
  <li>
    Coverage : 55 ether 
  </li>
  <li>
    Duration : 2 months
  </li>
  <input type="submit" value="submit" class="button button2" onclick="myFunction()"></input>
   
    
  </div>
 </div>
</form>
<script>
  function myFunction() {
    alert("Plan Availed receipt Downloaded");
  }
  </script>
</body>
</html>