<link href="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/js/bootstrap.min.js"></script> <script src="//code.jquery.com/jquery-1.11.1.min.js"></script> <!------ Include the above in your HEAD tag ----------> <div id="fullscreen_bg" class="fullscreen_bg"/> <form class="form-signin"> <div class="container"> <div class="row"> <div id="signupbox" style="margin-top:50px" class="mainbox col-md-6 col-md-offset-3 col-sm-8 col-sm-offset-2"> <div class="panel panel-info"> <div class="panel-heading"> <div class="panel-center">Add New Patient</div> </div> <div class="panel-body"> <form id="signupform" class="form-horizontal" role="form"> <div class="form-group"> <label for="Name" class="col-md-3 control-label">Name</label> <div class="col-md-9"> <input type="text" class="form-control" name="email" placeholder="Name"> </div> </div> <div class="form-group"> <label for="Age" class="col-md-3 control-label">Age</label> <div class="col-md-9"> <input type="text" class="form-control" name="Age" placeholder="Age"> </div> </div> <div class="form-group"> <label for="Sex" class="col-md-3 control-label">Sex</label> <div class="col-md-9"> <input type="text" class="form-control" name="Sex" placeholder="Sex"> </div> </div> <div class="form-group"> <label for="marital status" class="col-md-3 control-label">marital status</label> <div class="col-md-9"> <input type="text" class="form-control" name="marital status" placeholder="marital status"> </div> </div> <div class="form-group"> <label for="Address" class="col-md-3 control-label">Address</label> <div class="col-md-9"> <input type="text" class="form-control" name="Address" placeholder="Address"> </div> </div> <div class="form-group"> <label for="Mobile" class="col-md-3 control-label">Mobile</label> <div class="col-md-9"> <input type="text" class="form-control" name="Mobile" placeholder="Mobile"> </div> </div> <div class="form-group"> <label for="Date" class="col-md-3 control-label">Date</label> <div class="col-md-9"> <input type="text" class="form-control" name="Date" placeholder="Date"> </div> </div> <div class="form-group"> <label for="Job" class="col-md-3 control-label">Job</label> <div class="col-md-9"> <input type="text" class="form-control" name="Job" placeholder="Job"> </div> </div> <div class="form-group"> <label for="Telephone" class="col-md-3 control-label">Telephone</label> <div class="col-md-9"> <input type="text" class="form-control" name="Telephone" placeholder="Telephone"> </div> </div> <div class="form-group"> <!-- Button --> <div class="col-md-offset-3 col-md-9"> <button id="btn-signup" type="button" class="btn btn-info"><i class="icon-hand-right"></i> &nbspAdd Patient</button> </div> </div> </div> </div> </div> </div> </div> </form> </div>

body { background-color: #1b1b1b; padding-top: 40px; } .form-signin { max-width: 280px; padding: 15px; margin:100px; margin-top:70px; } .input-group-addon { background-color: rgb(50, 118, 177); border-color: rgb(40, 94, 142); color: rgb(255, 255, 255); } .form-signup input[type="text"],.form-signup input[type="password"] { border: 1px solid rgb(50, 118, 177); } .fullscreen_bg { position: fixed; top: 0; right: 0; bottom: 0; left: 0; background-size: cover; background-position: 50% 50%; background-image: url('http://i.imgur.com/h26izWg.jpg'); background-repeat:repeat; }