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newForm.html
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<!doctype html>
<html>
<head>
<title>Mobile Research Tool</title>
<meta name="viewport" content="width=device-width, initial-scale=1">
<link rel="stylesheet" href="css/styles.css">
</head>
<body>
<div data-role="page">
<div data-role="header" data-theme="b">
<h1>Survey Form</h1>
</div><!-- /header -->
<a href="#mypanel" data-role="button">Open Panel</a>
<div data-role="content">
<form>
<div data-role="fieldcontain">
<label for="text-13">Survey #</label>
<input type="text" data-clear-btn="true" name="text-13" id="text-13" value="">
</div>
<div data-role="fieldcontain">
<label for="select-choice-a" class="select">Negeri</label>
<select name="select-choice-a" id="select-choice-a" data-native-menu="false">
<option>Sila Pilih</option>
<option value="standard">Standard: 7 day</option>
<option value="rush">Rush: 3 days</option>
<option value="express">Express: next day</option>
<option value="overnight">Overnight</option>
</select>
<p>
<a href="#" data-role="button" data-inline="true">True</a>
<a href="#" data-role="button" data-inline="true">False</a>
</p>
</div>
</form>
</div><!-- /content -->
<div data-role="footer" data-theme="c">
<h4>ByteCentrix mobile solution</h4>
</div><!-- /footer -->
<div data-role="panel" id="mypanel" data-position="left" data-display="reveal">
<p>bla bla bla bla bla</p>
</div>
</div><!-- /page -->
<script src="js/jquery.js"></script>
<script src="js/jquery-mobile.js"></script>
</body>
</html>