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"Nuevo implante"
Bootstrap 3.3.0 Snippet by
chargoy
3.3.0
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<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 class="container"> <div class="row"> <h2>Nuevo implante</h2> </div> <form class="form-horizontal"> <fieldset> <!-- Form Name --> <legend>Nuevo implante</legend> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="Diente">Diente</label> <div class="col-md-4"> <select id="Diente" name="Diente" class="form-control"> <option value="1">1</option> <option value="2">2</option> <option value="3">3</option> <option value="4">4</option> <option value="5">5</option> <option value="6">6</option> <option value="7">7</option> <option value="8">8</option> <option value="9">9</option> <option value="10">10</option> </select> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="marca">Marca</label> <div class="col-md-4"> <select id="marca" name="marca" class="form-control"> <option value="1">Mark I</option> <option value="2">Mark II</option> </select> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="numerolote">Número de lote</label> <div class="col-md-4"> <input id="numerolote" name="numerolote" type="text" placeholder="12345" class="form-control input-md"> <span class="help-block">help</span> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="conexion">Conexión</label> <div class="col-md-4"> <input id="conexion" name="conexion" type="text" placeholder="" class="form-control input-md"> <span class="help-block">help</span> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="longitud">Longitud</label> <div class="col-md-4"> <input id="longitud" name="longitud" type="text" placeholder="" class="form-control input-md"> <span class="help-block">help</span> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="ancho">Ancho</label> <div class="col-md-4"> <input id="ancho" name="ancho" type="text" placeholder="" class="form-control input-md"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="tipoconexion">Tipo de conexión</label> <div class="col-md-4"> <input id="tipoconexion" name="tipoconexion" type="text" placeholder="" class="form-control input-md"> </div> </div> <!-- Textarea --> <div class="form-group"> <label class="col-md-4 control-label" for="notas">Notas</label> <div class="col-md-4"> <textarea class="form-control" id="notas" name="notas"></textarea> </div> </div> </fieldset> </form> </div>
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