{% load static %}
{% block title %}{% endblock %}


{% block head %}
<link rel="stylesheet" href="{% static  'accounts/signup.css' %}">
{% endblock %}

{% block body %}
<center><br><br><br><br>
<form method="post" >
    
    {% csrf_token %}

    <div class="container">
        <img class="brand-logo" src="{% static  'accounts/img/hospital-logo-green-blue_1043-66.avif' %}">
        <div class="brand-title">Presurgery</div>
        <div class="inputs">
            <label for="">username</label>
            <input id="username" name="username" type="text" placeholder="example: eli23"></input>

            <label for="">NAME</label>
            <input id="first_name" name="first_name" type="text" placeholder="example: eli"></input>
    
            <label for="">SURENAME</label>
            <input id="last_name" name="last_name" type="text" placeholder="example: rahimi"></input>
           
            <label for="">AGE</label>
            <input id="age" name="age" type="text" placeholder="example: 50"></input>
            
            <label for="">DISEASE</label>
            <input id="disease" name="disease" type="text" placeholder="example: bowel cancer"></input>
            
            <label for="">ADDRESS</label>
            <input id="address" name="address" type="text" placeholder="example: corso unione sovietica 75"></input>
            
            <label for="">Phone</label>
            <input id="phone" name="phone" type="text" placeholder="example: 3757032594"></input>
            
            <label for="">PASSWORD</label>
            <input id="password1" name="password1" type="password"></input>
            
            <label for="">RETYPE PASSWORD</label>
            <input id="password2" name="password2" type="password"></input>
            
            <button type="submit" >Submit</button>
        </div>
    </div>
</form>
</center>
{% endblock %}