How do I make a taxi search functionality?

Hello,

I am working on a website and I want to have a simple widget in my sidebar which does the following:
From field --> select where to go from
To field --> select where to go
Time --> select which time

People can then press search and there will be an output of:
1) From
2) To
3) Time
4) Calculated price --> set by standards

Any one any idea how to do this?

Thanks!

Greetings,
Jonathan Fokker