<!DOCTYPE html>
<html>
<head>
<meta charset="UTF-8">
<title></title>
</head>
<body>
<form action="http://www.google.com/" method="post">
<label for="fl">姓名:</label> <input type="text" id="fl"><br>
<label for="cm">公司:</label> <input type="text" id="cm"><br>
<label for="a1">地址:</label> <input type="text" id="a1"><br>
<label for="a2">地址2:</label> <input type="text" id="a2"><br>
<label for="ct">市:</label> <input type="text" id="ct"><br>
<label for="zc">邮编:</label> <input type="text" id="zc"><br>
<label for="st">省:</label> <input type="text" id="st"><br>
<label for="em">邮箱:</label> <input type="text" id="em"><br>
<label for="ph">电话:</label> <input type="text" id="ph"><br>
<label for="c1">持卡人姓名:</label> <input type="text" id="c1"><br>
<label for="c2">信用卡号码:</label> <input type="text" id="c2"><br>
<label for="c3">月:</label> <input type="text" id="c3"><br>
<label for="c4">年:</label> <input type="text" id="c4"><br>
</form>
</body>
</html>