- <td><?=_Middle Name(s)?><br>
- (<?=_optional?>)
- </td>
- <td><input class="form-control" type="text" name="mname" size="30" value="<?=$mname?>" autocomplete="off"></td>
- </tr>
-
- <tr>
- <td><?=_Last Name?>: </td>
- <td><input class="form-control" type="text" name="lname" size="30" value="<?=$lname?>" autocomplete="off"></td>
- </tr>
-
- <tr>
- <td><?=_Suffix?><br>
- (<?=_optional?>)</td>
- <td><input class="form-control" type="text" name="suffix" size="30" value="<?=$suffix?>" autocomplete="off"><br><?=_Please only write Name Suffixes into this field.?></td>
+ <td><?=_Date of Birth?>:<br>
+ (<?=_yyyy-mm-dd?>)</td>
+ <td><?=$dob?></td>
+ <td><?=_The required minimum age is ${dobmin} years.?></td>