Date in Input Form

How do I make a input code for a date in a form? (see picture)

My script process is in PHP, but the input form in HTML.




thanks.

 

If all you are looking for is a way for a user to input a date, just do:

<form action="">
<select name="Day">
<? php
for($i=1;$i<31;$i++) {
echo "<option value=\"".$i."\">".$i."</option>";
}
?>
</select>
</form>

Code (markup):

And then repeat that for each input.