WordPress Matrimony Search Form

I need a simple, dummy search form for a matrimony site running on WordPress. The form must display a live-looking “profile count” beside each filter, but the numbers can be hard-coded or generated with a lightweight script—this is purely for demonstration, not real user data.

Scope of the filters
• Country: India (only this one for now, though the code should let me add USA, Canada, etc. later without rewriting everything).
• City when India is chosen: Mumbai.
• Age: any range between 18 and 70, ideally handled with a slider or two dropdowns so I can tweak the min-max values.
• Marital status: single, divorced, widowed—feel free to name the field whatever works best; I just need separate counts to show.

Core expectations
• Built as a small plugin or a shortcode-ready snippet that I can drop into any page.
• Clean, responsive markup so it blends with my theme.
• An easy way in the admin to change or randomise the displayed counts.
• No external dependencies beyond common WordPress functions and, if needed, a touch of vanilla JavaScript or jQuery.

Deliverable
A zip (or Git repo) containing the plugin/snippet, a quick read-me with install steps, and brief notes on where to edit the dummy numbers.

If you’ve done similar directory or listing search forms before, that’s a big plus. Let me know how quickly you can turn this around and any questions you still have.