Write an HTML file that creates the following web page.

Dental Ireatment Informed Consent Form Patient information * denotes mandotory Name*: Age : Email Address: Date of Birth*: Type of Dental Procedure* : Discount Coupon code: Terms and conditions* I allow and authorize the clinic to perform this procedure to me. I understands the side effects of the medications given to me. I understand that I am not allowed to eat or drink 4-6 hours before the procedure