PHP:
<html>
<body>
<form name="siparis" method="post" action="siparis.php">
<table>
<tr>
<td align="right"><b>Adınız Soyadınız:</b></td>
<td><input type="text" name="adisoyadi"></td>
</tr>
<tr>
<td align="right"><b>Adres:</b></td>
<td><input type="text" name="adres"></td>
</tr>
<tr>
<td align="right"><b>Telefon:</b></td>
<td><input type="text" name="telefon"></td>
</tr>
</table>
<fieldset>
<legend>Çorbalar</legend>
<input type="radio" name="corba" value="mercimek">Mercimek<br>
<input type="radio" name="corba" value="ezogelin">Ezogelin<br>
<input type="radio" name="corba" value="yayla">Yayla<br>
<input type="radio" name="corba" value="iskembe">İşkembe<br>
</fieldset>
<fieldset>
<legend>Yemekler</legend>
<table>
<tr>
<td>
<input type="checkbox" name="corba" value="pilav">Pilav<br>
<input type="checkbox" name="corba" value="taskebabi">Tas Kebabı<br>
<input type="checkbox" name="corba" value="kuru">Kuru Fasulye<br>
<input type="checkbox" name="corba" value="kavurma">Et Kavurma
</td>
<td>
<input type="checkbox" name="corba" value="patlican">Patlıcan Kebap<br>
<input type="checkbox" name="corba" value="doner">Döner<br>
<input type="checkbox" name="corba" value="sote">Et Sote<br>
<input type="checkbox" name="corba" value="turlu">Türlü<br>
</td>
</tr>
</table>
</fieldset>
<fieldset>
<legend>Tatlılar</legend>
<input type="radio" name="tatli" value="kadayif">Kadayıf<br>
<input type="radio" name="tatli" value="kemalpasa">Kemalpaşa<br>
<input type="radio" name="tatli" value="kunefe">Künefe<br>
<input type="radio" name="tatli" value="sutlac">Sütlaç<br>
</fieldset>
<input type="submit" name="siparis" value="Sipariş Ver">
</form>
</body>
</html>