<link href="//netdna.bootstrapcdn.com/bootstrap/3.1.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//netdna.bootstrapcdn.com/bootstrap/3.1.0/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 class="container" style="margin-top:30px"> <div class="col-md-12"> <div class="panel panel-default"> <div class="panel-heading"><h3 class="panel-title"><strong>Add New Patient </strong></h3> <div style="float:right; font-size: 80%; position: relative; top:-10px"></div> </div> <div class="panel-body"> <form role="form"> <div class="alert alert-danger"> <a class="close" data-dismiss="alert" href="#">×</a>Incorrect Username or Password! </div> <div class="row"> <div class="col-md-6"> <div class="form-group"> <div class="col-sm-2 "> <input type="text" name="first_name" id="first_name" class="form-control " placeholder="Title" tabindex="1"> </div> <div class="col-sm-4 "> <input type="text" name="first_name" id="first_name" class="form-control " placeholder="First Name" tabindex="1"> </div> </div> </div> <div class="col-md-6"> <div class="form-group"> <input type="text" name="first_name" id="first_name" class="form-control" placeholder="Telephone (Home)" tabindex="1"> </div> </div> <div class="col-md-6"> <div class="form-group"> <input type="text" name="first_name" id="first_name" class="form-control " placeholder="Middle Name" tabindex="1"> </div> </div> <div class="col-md-6"> <div class="form-group"> <input type="text" name="first_name" id="first_name" class="form-control" placeholder="Telephone (Office)" tabindex="1"> </div> </div> </div> <div class="input-group"> <div class="checkbox" style="margin-top: 0px;"> <label> <input id="login-remember" type="checkbox" name="remember" value="1"> Remember me </label> </div> </div> <button type="submit" class="btn btn-success">Sign in</button> <hr style="margin-top:10px;margin-bottom:10px;" > <div class="form-group"> <div style="font-size:85%"> Don't have an account! <a href="#" onClick="$('#loginbox').hide(); $('#signupbox').show()"> Sign Up Here </a> </div> </div> </form> </div> </div> </div> </div>