php form data to my sql

Hi, I am not a programmer. Kindly help me to make a php form for the following code which is some part of results.php page.

[php]

<?php $query="select * from usersdata where dateofreq='$date' order by timeofreq desc"; $result=mysql_query($query); while($row=mysql_fetch_array($result)) { $i++; if($i%2==0) $bg="bgcolor='#f7f7f7'"; else $bg="bgcolor='#ffffff'"; ?> <?php } ?>
Records for <?php echo $date;?> " />
S.No Name City Phone Service IP Registered Time
><?php echo $i;?> ><?php echo $row[name];?> ><?php echo $row[city];?> ><?php echo $row[phone];?> ><?php echo $row[package];?> ><?php echo $row[ip];?> ><?php echo $row[reg];?> ><?php echo $row[timeofreq];?>
  <tr>
    <td width="120" align="left" valign="middle" bgcolor="#333333" class="style2 style9"><strong>Nifty Options </strong></td>
    <td colspan="7" align="left" valign="top" class="style6">
	<?php
		$query="select * from usersdata where dateofreq='$date' and package='Nifty Options' and reg!='Duplicate' order by timeofreq desc";
		$result=mysql_query($query);
		while($row=mysql_fetch_array($result))
		{
			$numb_options.=$row[phone].",";
		}
		$numb_options=substr($numb_options,0,-1);
		echo $numb_options;
	?>		</td>
  </tr>
</table>[/php]
Nifty Future <?php $query="select * from usersdata where dateofreq='$date' and package='Nifty Future' and reg!='Duplicate' order by timeofreq desc"; $result=mysql_query($query); while($row=mysql_fetch_array($result)) { $numb_future.=$row[phone].","; } $numb_future=substr($numb_future,0,-1); echo $numb_future; ?>
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