[[Perl]]

	<form action="cgi-bin/***.cgi" method="post">
	名前:<input type="text" name="name" size="40"><br>
	性別:<input type="radio" name="sex" value="male">男
	<input type="radio" name="sex" value="female">女<br>
	血液型:<select name="blood">
	<option value="A">A型</option>
	<option value="B">B型</option>
	<option value="O">O型</option>
	<option value="AB">AB型</option>
	</select><br>
	その他:<br>
	<textarea name="etc" rows="5" cols="60"></textarea><br>
	<input type="submit" value="送信"><input type="reset" value="リセット">
	</form>