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index.php
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<html>
<head>
<title>PHP Multiple Choice Questions and Answers</title>
<link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/bootstrap/4.3.1/css/bootstrap.min.css">
</head>
<body>
<div class="container">
<h1>Multiple Choice Questions Answers</h1>
<p>Please fill the details and answers the all questions-</p>
<form action="http://localhost:8013/pro2/score1.php" method="post">
<div class="form-group">
<strong>Name*:</strong><br/>
<input type="text" name="name" value="" required/>
</div>
<div class="form-group">
<strong>Age*:</strong><br/>
<input type="text" name="age" value="" required/>
</div>
<div class="form-group">
<strong>Phone*:</strong><br/>
<input type="text" name="phone" value="" required/>
</div>
<h3>Ques1 : Have you been having any trouble concentrating on daily tasks?</h3>
<div class="form-group">
<ol>
<li>
<input type="radio" name="q1" value="1" />I have been failing to meet deadlines.
</li>
<li>
<input type="radio" name="q1" value="2" />I am feeling overwhelmed by my daily tasks
</li>
<li>
<input type="radio" name="q1" value="3" />I have no motivation to start projects on time
</li>
<li>
<input type="radio" name="q1" value="4" />I avoid doing the task at hand as I know it may be more challenging
</li>
</ol>
</div>
<br/>
<div class="form-group">
<h3>Ques2 : Do you feel disheartened when you look at yourself daily while dressing up?</h3>
<ol>
<li>
<input type="radio" name="q2" value="1" />I feel dissatisfied when I look at myself and wish I was skinny/thinner
</li>
<li>
<input type="radio" name="q2" value="2" />Does not being the correct weight limit distress you daily.
</li>
<li>
<input type="radio" name="q2" value="3" />I avoid social situations with my friends/family due to how I look
</li>
<li>
<input type="radio" name="q2" value="4" />I feel my confidence has shattered due to how I look and avoid any situations outside my comfort zone
</li>
</ol>
</div>
<br/>
<div class="form-group">
<h3>Ques3 : Do you like being alone or does it cause any long-lasting sadness?</h3>
<ol>
<li>
<input type="radio" name="q3" value="1" /> I am introvert but miss being a little social
</li>
<li>
<input type="radio" name="q3" value="2" />Staying in self isolation makes me feel distant
</li>
<li>
<input type="radio" name="q3" value="3" />I am unable to make new friends.
</li>
<li>
<input type="radio" name="q3" value="4" />I am feeling lonely and am experiencing long periods of sadness.
</li>
</ol>
</div>
<div class="form-group">
<h3>Ques4 : How do you feel when you indulge in intoxicating yourself?</h3>
<ol>
<li>
<input type="radio" name="q4" value="1" /> Intoxicating myself gives the sense of peace that I do not feel when sober.
</li>
<li>
<input type="radio" name="q4" value="2" /> I feel excited and like doing it
</li>
<li>
<input type="radio" name="q4" value="3" /> Being intoxicated makes my feeling of anxiety go away.
</li>
<li>
<input type="radio" name="q4" value="4" /> Smoking a pack a day or being extremely drunk makes my stress go away
</li>
</ol>
</div>
<div class="form-group">
<h3>Ques5 : Did you face any injury to your body in past 4 weeks? Do you feel any pain?</h3>
<ol>
<li>
<input type="radio" name="q5" value="1" /> I have recovered physically and mentally from the pain
</li>
<li>
<input type="radio" name="q5" value="2" /> I have not recovered and am currently facing physical pain
</li>
<li>
<input type="radio" name="q5" value="3" /> I have recovered but am not mentally ready to perform tasks without being scared of feeling pain
</li>
<li>
<input type="radio" name="q5" value="4" /> Feeling pain has caused me to feel more frustrated than usual and makes me feel immobilized/paralyzed.
</li>
</ol>
</div>
<div class="form-group">
<h3>Ques6 : Does any sudden sounds startle you extremely or interfere with work and role functioning?</h3>
<ol>
<li>
<input type="radio" name="q6" value="1" /> Loud noises disturb me but do not impair my ability to do daily work
</li>
<li>
<input type="radio" name="q6" value="2" /> I feel extremely disturbed , irritated and frustrated at loud noises
</li>
<li>
<input type="radio" name="q6" value="3" /> I avoid going outside during festivals involving loud speakers and other triggers
</li>
<li>
<input type="radio" name="q6" value="4" /> I am unable to think after being triggered and feel paranoia, restlessness and paralyzed.
</li>
</ol>
</div>
<div class="form-group">
<h3>Ques7 : Have you been experiencing sleepless night</h3>
<ol>
<li>
<input type="radio" name="q7" value="1" /> I get a complete 7/8 hours of sleep
</li>
<li>
<input type="radio" name="q7" value="2" /> I feel stressed and am constantly worried about everything while sleeping
</li>
<li>
<input type="radio" name="q7" value="3" /> I am unable to calm my mind and relax my body while preparing to go to sleep
</li>
<li>
<input type="radio" name="q7" value="4" /> I feel short-bursts of paranoia and experience panic attacks as I feel someone is watching me
</li>
</ol>
</div>
<div class="form-group">
<h3>Ques8 : Have you experienced any sort of hazy illusions?</h3>
<ol>
<li>
<input type="radio" name="q8" value="1" /> I get a complete 7/8 hours of sleep
</li>
<li>
<input type="radio" name="q8" value="2" /> I can hear unusual sounds in my ears like clicking, banging and clapping and also see weird figures around me
</li>
<li>
<input type="radio" name="q8" value="3" /> I experienced an increased number of nightmares that occur due to paranoia
</li>
<li>
<input type="radio" name="q8" value="4" /> I have a regular sleep schedule and do not experience any illusions
</li>
</ol>
</div>
<div class="form-group">
<h3>Ques9 : Have you felt like an unnecessary load on others?</h3>
<ol>
<li>
<input type="radio" name="q9" value="1" /> I do not feel as such
</li>
<li>
<input type="radio" name="q9" value="2" /> I have been feeling distant and disinterested in everything around me
</li>
<li>
<input type="radio" name="q9" value="3" /> I feel like a failure due to my lack of achievement regarding my goals
</li>
<li>
<input type="radio" name="q9" value="4" /> I have given up and feel it would be easier to give away every prized possession and commit suicide
</li>
</ol>
</div>
<div class="form-group">
<input type="submit" value="Submit" name="submit" class="btn btn-primary"/>
</div>
</form>
</div>
</body>