<form>

Username : <input name="Username"

type="text" id="Username" />
<br>
Password : <input name="Password"
type="password" id="Password" />
</form>

Jawaban:<br>
<form>
<input name="Jawaban"
type="radio" value="a."> a.
<br>
<input name="Jawaban"
type="radio" value="b."> b.
<br>
<input name="Jawaban"
type="radio" value="c."> c.
<br>
<input name="Jawaban"
type="radio" value="d."> d.
<br>
</form>

<form>
<input type="submit" value="kirim" />
</form>