roll20-character-sheets/Diaspora/diaspora.html

<div class="container2">
  <div class="container1">
    <div class="col1">
      <div class="container">
        <input class="single larger" type="text" name="attr_name" placeholder="Name" />
        <input class="single larger" type="text" name="attr_homeworld" placeholder="Homeworld" />
      </div>
      <div class='group'>
        <legend>Skills</legend>
        <div class="skill_rank">Rank 5</div>
        <input type="text" name="attr_skillLevelFiveOne" placeholder="Rank 5 skill">

        <div class="skill_rank">Rank 4</div>
        <input type="text" name="attr_skillLevelFourOne" placeholder="Rank 4 skill">
        <input type="text" name="attr_skillLevelFourTwo" placeholder="Rank 4 skill">

        <div class="skill_rank">Rank 3</div>
        <input type="text" name="attr_skillLevelThreeOne" placeholder="Rank 3 skill">
        <input type="text" name="attr_skillLevelThreeTwo" placeholder="Rank 3 skill">
        <input type="text" name="attr_skillLevelThreeThree" placeholder="Rank 3 skill">

        <div class="skill_rank">Rank 2</div>
        <input type="text" name="attr_skillLevelTwoOne" placeholder="Rank 2 skill">
        <input type="text" name="attr_skillLevelTwoTwo" placeholder="Rank 2 skill">
        <input type="text" name="attr_skillLevelTwoThree" placeholder="Rank 2 skill">
        <input type="text" name="attr_skillLevelTwoFour" placeholder="Rank 2 skill">

        <div class="skill_rank">Rank 1</div>
        <input type="text" name="attr_skillLevelOneOne" placeholder="Rank 1 skill">
        <input type="text" name="attr_skillLevelOneTwo" placeholder="Rank 1 skill">
        <input type="text" name="attr_skillLevelOneThree" placeholder="Rank 1 skill">
        <input type="text" name="attr_skillLevelOneFour" placeholder="Rank 1 skill">
        <input type="text" name="attr_skillLevelOneFive" placeholder="Rank 1 skill">
      </div>

      <div class='group'>
        <legend>Stunts</legend>
        <input type="text" name="attr_stuntOne" placeholder="Stunt">
        <input type="text" name="attr_stuntTwo" placeholder="Stunt">
        <input type="text" name="attr_stuntThree" placeholder="Stunt">
      </div>
    </div>
    <div class="col2">
      <div class='group'>
        <legend>Cluster</legend>
        <textarea name="attr_cluster"></textarea>
      </div>


      <div class='group'>
        <legend>Aspects</legend>
        <input type="text" name="attr_aspectOne" placeholder="Stunt">
        <input type="text" name="attr_aspectTwo" placeholder="Stunt">
        <input type="text" name="attr_aspectThree" placeholder="Stunt">
        <input type="text" name="attr_aspectFour" placeholder="Stunt">
        <input type="text" name="attr_aspectFive" placeholder="Stunt">
        <input type="text" name="attr_aspectSix" placeholder="Stunt">
        <input type="text" name="attr_aspectSeven" placeholder="Stunt">
        <input type="text" name="attr_aspectEigth" placeholder="Stunt">
        <input type="text" name="attr_aspectNine" placeholder="Stunt">
        <input type="text" name="attr_aspectTen" placeholder="Stunt">
      </div>

      <div class='group'>
        <legend>Stress Tracks</legend>
        <div>Health</div>
        <input class="solid" type="checkbox" name="attr_healthOne" />
        <input class="solid" type="checkbox" name="attr_healthTwo" />
        <input class="solid" type="checkbox" name="attr_healthThree" />
        <input class="gray" type="checkbox" name="attr_healthFour" />
        <input class="gray" type="checkbox" name="attr_healthFive" />
        <input class="gray" type="checkbox" name="attr_healthSix" />
        <input class="gray" type="checkbox" name="attr_healthSeven" />

        <div>Composure</div>
        <input class="solid" type="checkbox" name="attr_composureOne" />
        <input class="solid" type="checkbox" name="attr_composureTwo" />
        <input class="solid" type="checkbox" name="attr_composureThree" />
        <input class="gray" type="checkbox" name="attr_composureFour" />
        <input class="gray" type="checkbox" name="attr_composureFive" />
        <input class="gray" type="checkbox" name="attr_composureSix" />
        <input class="gray" type="checkbox" name="attr_composureSeven" />

        <div>Wealth</div>
        <input class="solid" type="checkbox" name="attr_wealthOne" />
        <input class="solid" type="checkbox" name="attr_wealthTwo" />
        <input class="solid" type="checkbox" name="attr_wealthThree" />
        <input class="gray" type="checkbox" name="attr_wealthFour" />
        <input class="gray" type="checkbox" name="attr_wealthFive" />
        <input class="gray" type="checkbox" name="attr_wealthSix" />
        <input class="gray" type="checkbox" name="attr_wealthSeven" />
      </div>

      <div class='group'>
        <legend>Consequence</legend>
          <input type="text" class="single" name="attr_mildConsequence" placeholder="Mild consequence">
          <input type="text" class="single" name="attr_mediumConsequence" placeholder="Medium consequence">
          <input type="text" class="single" name="attr_severeConsequence" placeholder="Severe consequence">
      </div>

    </div>
  </div>
</div>
<div class="container end">
  <div class='group'>
    <legend>Gear &amp; Stuff</legend>
    <textarea name="attr_gearStuff"></textarea>
  </div>
</div>