"Bevat-OUT OF OFFICE"
Bootstrap 3.0.0 Snippet by cresignsys

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<link href="//netdna.bootstrapcdn.com/bootstrap/3.0.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css">
<script src="//netdna.bootstrapcdn.com/bootstrap/3.0.0/js/bootstrap.min.js"></script>
<script src="//code.jquery.com/jquery-1.11.1.min.js"></script>
<!------ Include the above in your HEAD tag ---------->
<form class="form-horizontal">
<fieldset>
<!-- Form Name -->
<legend>Bevat-OUT OF OFFICE</legend>
<!-- Text input-->
<div class="form-group">
<label class="col-md-4 control-label" for="Name">Name</label>
<div class="col-md-4">
<input id="Name" name="Name" type="text" placeholder="" class="form-control input-md">
</div>
</div>
<!-- Text input-->
<div class="form-group">
<label class="col-md-4 control-label" for="Date">Date</label>
<div class="col-md-4">
<input id="Date" name="Date" type="text" placeholder="" class="form-control input-md">
</div>
</div>
<!-- Text input-->
<div class="form-group">
<label class="col-md-4 control-label" for="ACTUALTIMEIN">ACTUAL TIME IN (Office or Work Place)</label>
<div class="col-md-4">
<input id="ACTUALTIMEIN" name="ACTUALTIMEIN" type="text" placeholder="" class="form-control input-md">
</div>
</div>
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