Wget / Curl auto fill html form

Hello, I need programmer who can write php script that can auto fill this html form [login to view URL] . Value to fill in form can get from my database ( I will let you know for database login later ) . Get card number from my database and fill in first text box . (14 digit) Get id number from my database and fill in second text box. Get casdhash number from my database and fill in third text box. Example of value can see at attachment.