<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="//cdnjs.cloudflare.com/ajax/libs/jquery/3.2.1/jquery.min.js"></script> <!------ Include the above in your HEAD tag ----------> <div class="container"> <div class="row"> <div class="col-md-12"> <div class="container-fluid"> <div class="row"> <div class="col-md-6 col-sm-6 col-xs-12"> <form method="post"> <div class="form-group "> <label class="control-label requiredField" for="name"> Name <span class="asteriskField"> * </span> </label> <input class="form-control" id="name" name="name" placeholder="Full Name" type="text"/> </div> <div class="form-group "> <label class="control-label requiredField" for="tel"> Mobile No# <span class="asteriskField"> * </span> </label> <input class="form-control" id="tel" name="tel" type="text"/> </div> <div class="form-group "> <label class="control-label " for="select"> Select State </label> <select class="select form-control" id="select" name="select"> <option value="New Delhi"> New Delhi </option> <option value="Banglore"> Banglore </option> <option value="Jaipur"> Jaipur </option> <option value="Chennai"> Chennai </option> <option value="Ahmedabad"> Ahmedabad </option> <option value="Mumbai"> Mumbai </option> </select> </div> <div class="form-group "> <label class="control-label requiredField" for="city"> City <span class="asteriskField"> * </span> </label> <input class="form-control" id="city" name="city" type="text"/> </div> <div class="form-group "> <label class="control-label requiredField" for="pincode"> Pincode <span class="asteriskField"> * </span> </label> <input class="form-control" id="pincode" name="pincode" type="text"/> </div> <div class="form-group "> <label class="control-label requiredField" for="date"> Date <span class="asteriskField"> * </span> </label> <input class="form-control" id="date" name="date" placeholder="MM/DD/YYYY" type="text"/> </div> <div class="form-group "> <label class="control-label " for="time"> time </label> <select class="select form-control" id="time" name="time"> <option value="5am-7am"> 5am-7am </option> <option value="7am-9am"> 7am-9am </option> <option value="9am-11am"> 9am-11am </option> <option value="11am-1pm"> 11am-1pm </option> <option value="1pm-3pm"> 1pm-3pm </option> <option value="3pm-5pm"> 3pm-5pm </option> <option value="5pm-7pm"> 5pm-7pm </option> <option value="7pm-9pm"> 7pm-9pm </option> <option value="Other time need to discuss"> Other time need to discuss </option> </select> </div> <div class="form-group"> <div> <button class="btn btn-primary " name="submit" type="submit"> Submit </button> </div> </div> </form> </div> </div> </div> </div> </div> </div>