price=480;
<font size=+2>Please submit your Address and Item name below</font><BR>
<form method=post action=cart.php>
<input type=hidden name=sc value=0420114804>
<input type=hidden name=ac value=add>
<input type=hidden name=price value=480>
<input type=hidden name=item value=Breastoptim>
<input type=hidden name=pack value=180>
<font size=+3>Name & Address : <input type=text name=add size=80><BR>
Item : <input type=text name=item size=80 value="Breastoptim 180"><BR></font>
<input type=submit value="Add to Cart">
<font size=+3><P>Amount charged is MRP - 20% Discount + Rs100 Courier<BR>
Please get in touch with Whatsapp 9810571993 with your Address and Item Name.</font>
</form>