"Order Form"
Bootstrap 3.1.0 Snippet by sourabhkadam

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<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">
<div class="row">
<form class="form-horizontal">
<fieldset>
<!-- Form Name -->
<legend>Order</legend>
<!-- Text input-->
<div class="form-group">
<label class="col-md-4 control-label" for="textinputname">Full Name</label>
<div class="col-md-4">
<input id="textinputname" name="textinputname" type="text" placeholder="Full Name" class="form-control input-md" required="">
</div>
</div>
<!-- Text input-->
<div class="form-group">
<label class="col-md-4 control-label" for="textinputmobile">Mobile</label>
<div class="col-md-4">
<input id="textinputmobile" name="textinputmobile" type="text" placeholder="Mobile No" class="form-control input-md">
</div>
</div>
<!-- Text input-->
<div class="form-group">
<label class="col-md-4 control-label" for="textinputmobilealt">Alternate Mobile</label>
<div class="col-md-4">
<input id="textinputmobilealt" name="textinputmobilealt" type="text" placeholder="alternate mobile no." class="form-control input-md">
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