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indexx.php
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<!DOCTYPE html>
<html lang="en">
<head>
<title>Patient Details</title>
</head>
<body>
<center>
<h1>SignUp Details</h1>
<form action="insertt.php" method="post">
<p>
<label for="firstName">First Name:</label>
<input type="text" name="first_name" id="firstName">
</p>
<p>
<label for="lastName">Last Name:</label>
<input type="text" name="last_name" id="lastName">
</p>
<p>
<label for="Gender">Gender:</label>
<input type="text" name="gender" id="Gender">
</p>
<p>
<label for="Address">Address:</label>
<input type="text" name="address" id="Address">
</p>
<p>
<label for="emailAddress">Email Address:</label>
<input type="text" name="email" id="emailAddress">
</p>
<input type="submit" value="Submit">
</form>
</center>
</body>
</html>