"signup"
Bootstrap 3.0.0 Snippet by ranaldschulz

<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 ----------> <div class="container" id="wrap"> <div class="row"> <div class="col-md-6 col-md-offset-3"> <form action="r" method="post" accept-charset="utf-8" class="form" role="form"> <legend>Sign Up</legend> <div class="row"> <div class="col-xs-6 col-md-6"> <input type="text" name="firstname" value="" class="form-control input-lg" placeholder="First Name" /> </div> <div class="col-xs-6 col-md-6"> <input type="text" name="lastname" value="" class="form-control input-lg" placeholder="Last Name" /> </div> </div> <input type="text" name="email" value="" class="form-control input-lg" placeholder="Your Email"/> <input type="password" name="password" value="" class="form-control input-lg" placeholder="Password"/> <input type="password" name="confirm_password" value="" class="form-control input-lg" placeholder="Confirm Password"/> <select name="user" value="" class="form-control input-lg"> <option value="01">Doctor</option> <option value="02">Patient</option> <option value="03">Service Provider</option> </select> <div class="row"> <div class="col-xs-6 col-md-6"> <select name="gender" value="" class="form-control input-lg" placeholder="Gender"> <option value="01">Male</option> <option value="02">Female</option> </select> </div> <div class="col-xs-6 col-md-6"> <div class="form-group"> <div class='input-group date' id='datepicker1'> <input type='text' class="form-control input-lg" /> <span class="input-group-addon"> <span class="glyphicon glyphicon-calendar"></span> </span> </div> </div> </div> </div> <button class="btn btn-lg btn-primary btn-block signup-btn" type="submit"> Create account</button> </form> </div> </div> </div> </div>
#wrap{ background-image: -ms-linear-gradient(top, #FFFFFF 0%, #D3D8E8 100%); /* Mozilla Firefox */ background-image: -moz-linear-gradient(top, #FFFFFF 0%, #D3D8E8 100%); /* Opera */ background-image: -o-linear-gradient(top, #FFFFFF 0%, #D3D8E8 100%); /* Webkit (Safari/Chrome 10) */ background-image: -webkit-gradient(linear, left top, left bottom, color-stop(0, #FFFFFF), color-stop(1, #D3D8E8)); /* Webkit (Chrome 11+) */ background-image: -webkit-linear-gradient(top, #FFFFFF 0%, #D3D8E8 100%); /* W3C Markup, IE10 Release Preview */ background-image: linear-gradient(to bottom, #FFFFFF 0%, #D3D8E8 100%); background-repeat: no-repeat; background-attachment: fixed; } legend{ color:#141823; font-size:25px; font-weight:bold; } .signup-btn { background: #79bc64; background-image: -webkit-linear-gradient(top, #79bc64, #578843); background-image: -moz-linear-gradient(top, #79bc64, #578843); background-image: -ms-linear-gradient(top, #79bc64, #578843); background-image: -o-linear-gradient(top, #79bc64, #578843); background-image: linear-gradient(to bottom, #79bc64, #578843); -webkit-border-radius: 4; -moz-border-radius: 4; border-radius: 4px; text-shadow: 0px 1px 0px #898a88; -webkit-box-shadow: 0px 0px 0px #a4e388; -moz-box-shadow: 0px 0px 0px #a4e388; box-shadow: 0px 0px 0px #a4e388; font-family: Arial; color: #ffffff; font-size: 20px; padding: 10px 20px 10px 20px; border: solid #3b6e22 1px; text-decoration: none; } .signup-btn:hover { background: #79bc64; background-image: -webkit-linear-gradient(top, #79bc64, #5e7056); background-image: -moz-linear-gradient(top, #79bc64, #5e7056); background-image: -ms-linear-gradient(top, #79bc64, #5e7056); background-image: -o-linear-gradient(top, #79bc64, #5e7056); background-image: linear-gradient(to bottom, #79bc64, #5e7056); text-decoration: none; } .navbar-default .navbar-brand{ color:#fff; font-size:30px; font-weight:bold; } .form .form-control { margin-bottom: 10px; } @media (min-width:768px) { #home{ margin-top:50px; } #home .slogan{ color: #0e385f; line-height: 29px; font-weight:bold; } }
$(function () { $('#datepicker1').datepicker('show'); });

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