Session Opened: Path="/opt/alt/php81/var/lib/php/session", Name="PHPSESSID"
Session read: ID="11r8622jleitfea7aps0ro1snk"
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Form Demo with LABEL, FIELDSET Elements

Personal Information

First Name:

Last Name:

Age: Select Under 18 19 to 21 21 to 33 34 to 45 46 to 65 Over 65

Material Status: Single Maried

Current Medication

Are you currently taking any medication? Yes No

If you are currently taking medication, please indicate it in the space below:

Activities

Baseball
Bowling
Running/Jogging
Tiddily Winks
Solitaire

Session written: ID="11r8622jleitfea7aps0ro1snk"
   Data="count|i:1;foo|s:3:"bar";bar|s:3:"baz";"
Session closed.