<!DOCTYPE html>
<html>
<link href="https://cdn.jsdelivr.net/npm/bootstrap@5.0.2/dist/css/bootstrap.min.css" rel="stylesheet"
  integrity="sha384-EVSTQN3/azprG1Anm3QDgpJLIm9Nao0Yz1ztcQTwFspd3yD65VohhpuuCOmLASjC" crossorigin="anonymous" />
<script src="https://cdn.jsdelivr.net/npm/bootstrap@5.0.2/dist/js/bootstrap.bundle.min.js"
  integrity="sha384-MrcW6ZMFYlzcLA8Nl+NtUVF0sA7MsXsP1UyJoMp4YLEuNSfAP+JcXn/tWtIaxVXM" crossorigin="anonymous"></script>

<head>
  <meta name="viewport" content="width=device-width, initial-scale=1" />
  <!-- เรียกใช้ Bootstrap 5 -->
  <link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/bootstrap/5.3.0/css/bootstrap.min.css"
    integrity="sha512-jRcyS0JzoOe9Mq3OEn5Q+U67/l7o+f+B2dG1mVWmHJ+ud7M9XmFmB7GJj6o4b4Yl+SGoSyKkfcf1FbzN1Sd9zA=="
    crossorigin="anonymous" referrerpolicy="no-referrer" />
  <link rel="stylesheet" href="https://fonts.googleapis.com/css?family=Prompt">
  <style>
    body {
      font-family: 'Prompt';
    }

    .nav {

      box-sizing: border-box;
      width: 305px;
      height: 1024px;
      left: 0px;
      top: 0px;
      background: #ffffff;
      border: 1px solid rgba(0, 0, 0, 0.3);
      font-style: normal;
      font-weight: 400;
      font-size: 24px;

    }

    .h1 {
      position: absolute;
      width: 400px;
      height: 48px;
      left: 435px;
      top: 116px;
    }

    .row {
      box-sizing: border-box;

      position: absolute;
      width: 928px;
      height: 695px;
      left: 405px;
      top: 230px;

      background: #FFFFFF;
      border: 1px solid;
      border-radius: 10px;

    }




    .col-md-6 input[type="date"] {
      width: 420px;
      height: 30px;
      left: 888px;
      top: 481px;
      border: none;
      border-bottom: 1px solid black;
      border-radius: 0px;
    }

    #validationCustom01, InputEmail1 {
      border: none;
      border-bottom: 1px solid black;
      border-radius: 0px;
    }
  </style>
</head>

<body>
  <nav class="navbar navbar-light bg-light border border-primary">
    <div class="container-fluid">
      <a class="btn btn-outline-success">Navbar</a>
      <form class="d-flex">
        <button class="btn btn-outline-success me-2" type="submit">
          name
        </button>
        <button class="btn btn-outline-success" type="submit">out</button>
      </form>
    </div>
  </nav>
  <div class="h1 text-center ">ลงทะเบียนสมาชิก</div>


  <ul class="nav flex-column >
      <li class=" nav-item">
    <a class="nav-link" href="#">ลงทะเบียนสมาชิก</a>
    </li>
    <li class="nav-item">
      <a class="nav-link" href="#">อนุมัติสมาชิก</a>
    </li>
    <li class="nav-item">
      <a class="nav-link" href="#">คำนวนเงิน</a>
    </li>
    <li class="nav-item">
      <a class="nav-link" href="#">ปรับปรุงข้อมูลสมาชิก</a>
    </li>
    <li class="nav-item">
      <a class="nav-link" href="#">หลักฐานการแจ้งฝากเงิน</a>
    </li>
    <li class="nav-item">
      <a class="nav-link" href="#">รายงาน</a>
    </li>
  </ul>


  <form class="row  border border-primary needs-validation " novalidate>
    <div></div>
    <div class="col-md-2 ">
      <label for="validationCustom01" class="form-label">คำนำหน้า</label>
      <input type="text" class="form-control" id="validationCustom01" >
    </div>
    <div class="col-md-5">
      <label for="validationCustom01" class="form-label">ชื่อ</label>
      <input type="text" class="form-control" id="validationCustom01" >
    </div>
    <div class="col-md-5">
      <label for="validationCustom01" class="form-label">นามสกุล</label>
      <input type="text" class="form-control" id="validationCustom01" >
    </div>

    <div class="col-md-2">
      <label for="validationCustom01" class="form-label">Prefix</label>
      <input type="text" class="form-control" id="validationCustom01" >
    </div>
    <div class="col-md-5">
      <label for="validationCustom01" class="form-label">First Name</label>
      <input type="text" class="form-control" id="validationCustom01" >
    </div>
    <div class="col-md-5">
      <label for="validationCustom01" class="form-label">Last Name</label>
      <input type="text" class="form-control" id="validationCustom01" >
    </div>

    <div class="col-md-6">
      <label for="validationCustom01" class="form-label">เลขบัตรประชาชน</label>
      <input type="text" class="form-control" id="validationCustom01" >
    </div>
    <div class="col-md-6 ">
      <label for="Birthday">วันเกิด</label><br>
      <div class="mt-3">
              <input type="date" id="Birthday" name="Birthday" required>
      </div>
    </div>

    <div class="col-md-6">
      <label for="validationCustom01" class="form-label">ที่อยู่ตามบัตรประชาชน</label>
      <input type="text" class="form-control" id="validationCustom01" >
    </div>
    <div class="col-md-6">
      <label for="validationCustom01" class="form-label">ตำบล/แขวง</label>
      <input type="text" class="form-control" id="validationCustom01" >
    </div>

    <div class="col-md-4">
      <label for="validationCustom01" class="form-label">อำเภอ</label>
      <input type="text" class="form-control" id="validationCustom01" >
    </div>
    <div class="col-md-4">
      <label for="validationCustom01" class="form-label">จังหวัด</label>
      <input type="text" class="form-control" id="validationCustom01" >
    </div>
    <div class="col-md-4">
      <label for="validationCustom01" class="form-label">รหัสไปรษณีย์</label>
      <input type="text" class="form-control" id="validationCustom01" >
    </div>

    <div class="col-md-6">
      <label for="validationCustom01" class="form-label">อีเมล</label>
      <input type="email" class="form-control" id="validationCustom01" >
      <div class="invalid-feedback">
        กรุณากรอกอีเมล
      </div>
    </div>
    <div class="col-md-6">
      <label for="validationCustom01" class="form-label">ยืนยันอีเมล</label>
      <input type="email" class="form-control" id="validationCustom01">
    </div>
    <div class="col-12 text-end">
      <a class="btn btn-primary"
        href=http://127.0.0.1:5501/ลงทะเบียนสมาชิกต่อ.html"
        role="button">ถัดไป</a>
    </div>
  </form>
</body>

</html>