q13

 <form action="/submit" method="post">

  <input type="text" name="name" placeholder="Enter Name">

  <input type="text" name="rollno" placeholder="Enter Roll No.">

  <input type="text" name="age" placeholder="Enter Age">

  <input type="date" name="dob" placeholder="Enter DOB">

  <input type="submit" value="Submit Query">

</form>