Design a Front End and Back End Simple Website using PHP (or other language)

I am looking for someone to build me a back end and front end database using PHP (or other language). The front end will be very simple, minimalistic and have very few colors. It will only have text and then fields to enter data into. No images, no photos, no logos. You can move through the fields by hitting ‘tab’. See Sheet 1. There will be lots of fields. For example: Name: (text) Age: (text) Gender: (Male or female) The second page of the front end will have a display of the fields and the answers according to a layout. The layout is important. It is like Sheet 2. This is where data is displayed (not typed in) For example: Name: Patel Age: 43 Gender: Male There will be a standard list of fields for the first page which may be changed on the frontend/backend by me (I cannot code). I want to be able to edit the field and data type. In addition I want certain fields to automatically populate other fields. For example Home town: Mumbai Do you speak Hindi: (Yes or No) Or Hometown: Beijing Are you Chinese: (Yes or No) I will buy the domain and website to host this on. I want to be able to input the data which is on the first page on a computer (Windows or iOS). I want the second page to be an image. I want four buttons on this page: 1) Send this image via a text (which then returns to the second page after a confirmation message) 2) Email this image (which then returns to the second page after a confirmation message) or 3) Go back (which goes back to the first screen to change the fields/data) or 4) Save There will be a user login where the standard template loads. The user has the ability to modify/delete/add different fields on the front end. The last 20 entries are saved. There is no rush on the deadline. Fonts: Open Sans Bold or Futura PT