Designee template with functionality

I need a Html file just like the psd file i had attached. I need a functionality with that page , there are two dropdown (From and To). Whenever i select any item from From dropdown then To dropdown should be fill automatically. And its should be compatible for all browsers. For example there are two dropdown one for state and other for city , suppose i select any state form first dropdown then corresponding city of that state should be automatically filled into city dropdown from database. ## Deliverables I need a Html file just like the psd file i had attached. I need a functionality with that page , there are two dropdown (From and To). Whenever i select any item from From dropdown then To dropdown should be fill automatically. And its should be compatible for all browsers. For example there are two dropdown one for state and other for city , suppose i select any state form first dropdown then corresponding city of that state should be automatically filled into city dropdown from database.