"Address Details Modal Form"
Bootstrap 3.1.0 Snippet by alexandred95

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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 ----------> <html lang="pt"> <head> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <meta charset="utf-8"> <title>Bootstrap CRETA Teste</title> <figure> <center><img src="img/creta.png" alt="CRETA" width="550" height="270" class="img-responsive" ></center> </figure> <link href="css/bootstrap.css" rel="stylesheet"> <link href="css/style.css" rel="stylesheet"> <script type="text/javascript" src="js/jquery.min.js"></script> <script type="text/javascript" src="js/scripts.js"></script> </head> <div class="row"> <div class="col-md-6 col-md-offset-3 "> <form class="form-horizontal" role="form"> <fieldset> <!-- Form Name --> <legend>Tratamento</legend> <!-- Text input--> <div class="form-group"> <label class="col-sm-2 control-label" for="textinput">RGH</label> <div class="col-sm-2 ; col-md-4"> <input type="text" placeholder="State" class="form-control"> </div> <label class="col-sm-2 control-label" for="textinput">RA</label> <div class="col-sm-4" > <input type="text" placeholder="Post Code" class="form-control"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-sm-2 control-label" for="textinput">City</label> <div class="col-sm-10"> <input type="text" placeholder="City" class="form-control"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-sm-2 control-label" for="textinput">State</label> <div class="col-sm-4"> <input type="text" placeholder="State" class="form-control"> </div> <label class="col-sm-2 control-label" for="textinput">Postcode</label> <div class="col-sm-4"> <input type="text" placeholder="Post Code" class="form-control"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-sm-2 control-label" for="textinput">Country</label> <div class="col-sm-10"> <input type="text" placeholder="Country" class="form-control"> </div> </div> <div class="form-group"> <div class="col-sm-offset-2 col-sm-10"> <div class="pull-right"> <button type="submit" class="btn btn-default">Cancel</button> <button type="submit" class="btn btn-primary">Save</button> </div> </div> </div> </fieldset> </form> </div><!-- /.col-lg-12 --> </div><!-- /.row --> <body> </body> </html>

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