get input and generate output

[me]

Hi

How can I create a page that have these objects: 1-textbox 2-listbox 3-bottom

from textbox user enter some string and in output show each part in appropriate section.

e.g.

user input: Jack Mars Texas 3515615611 001234531531

output: name: Jack Mars , city: Texas, phone: 3515615611, mobile: 001234531531

Any recommendation?