"7 Osobné údaje žiadateľa"
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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"> <form class="form-horizontal"> <fieldset> <!-- Form Name --> <legend>Osobné údaje žiadateľa</legend> <!-- Text input--> <div class="control-group"> <label class="control-label" for="A_001_001_Titul">Titul</label> <div class="controls"> <input id="A_001_001_Titul" name="A_001_001_Titul" type="text" placeholder="Titul" class="input-xlarge"> <p class="help-block">?</p> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="A_001_002_Meno">Meno</label> <div class="controls"> <input id="A_001_002_Meno" name="A_001_002_Meno" type="text" placeholder="Meno" class="input-xlarge"> <p class="help-block">?</p> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="A_001_003_Druhe_meno">Druhé meno</label> <div class="controls"> <input id="A_001_003_Druhe_meno" name="A_001_003_Druhe_meno" type="text" placeholder="Druhé meno" class="input-xlarge"> <p class="help-block">?</p> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="A_001_004_Priezvisko">Priezvisko</label> <div class="controls"> <input id="A_001_004_Priezvisko" name="A_001_004_Priezvisko" type="text" placeholder="Priezvisko" class="input-xlarge"> <p class="help-block">?</p> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="A_001_018_Cele_meno_podla_pasu">Celé meno podľa pasu</label> <div class="controls"> <input id="A_001_018_Cele_meno_podla_pasu" name="A_001_018_Cele_meno_podla_pasu" type="text" placeholder="Celé meno podľa pasu" class="input-xlarge"> <p class="help-block">?</p> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="A_001_005_Rodne_priezvisko">Rodné priezvisko</label> <div class="controls"> <input id="A_001_005_Rodne_priezvisko" name="A_001_005_Rodne_priezvisko" type="text" placeholder="Rodné priezvisko" class="input-xlarge"> <p class="help-block">?</p> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="A_001_006_Predchadzajuce_priezviska">Predchádzajúce priezviská</label> <div class="controls"> <input id="A_001_006_Predchadzajuce_priezviska" name="A_001_006_Predchadzajuce_priezviska" type="text" placeholder="Predchádzajúce priezviská" class="input-xlarge"> <p class="help-block">?</p> </div> </div> <hr> <!-- Multiple Radios --> <div class="control-group"> <label class="control-label" for="pohlavie">Pohlavie</label> <div class="controls"> <label class="radio" for="pohlavie-0"> <input type="radio" name="pohlavie" id="pohlavie-0" value="Muž" checked="checked"> Muž </label> <label class="radio" for="pohlavie-1"> <input type="radio" name="pohlavie" id="pohlavie-1" value="Žena"> Žena </label> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="A_001_009_Datum_narodenia">Dátum narodenia</label> <div class="controls"> <input id="A_001_009_Datum_narodenia" name="A_001_009_Datum_narodenia" type="text" placeholder="DD/MM/YYYY" class="input-xlarge"> <p class="help-block">?</p> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="A_001_010_Miesto_narodenia">Miesto narodenia (Mesto/Obec)</label> <div class="controls"> <input id="A_001_010_Miesto_narodenia" name="A_001_010_Miesto_narodenia" type="text" placeholder="Miesto narodenia" class="input-xlarge"> <p class="help-block">?</p> </div> </div> <!-- Select Basic --> <div class="control-group"> <label class="control-label" for="A_001_011_Stat_narodenia">Štát narodenia</label> <div class="controls"> <select id="A_001_011_Stat_narodenia" name="A_001_011_Stat_narodenia" class="input-xlarge"> <option>Ruská federácia</option> <option>Ukrajina</option> <option>ČIna</option> <option>Južná Kórea</option> </select> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="A_001_012_Narodnost">Národnosť</label> <div class="controls"> <input id="A_001_012_Narodnost" name="A_001_012_Narodnost" type="text" placeholder="Národnosť" class="input-xlarge"> <p class="help-block">?</p> </div> </div> <!-- Select Basic --> <div class="control-group"> <label class="control-label" for="A_001_013_Obcianstvo">Občianstvo</label> <div class="controls"> <select id="A_001_013_Obcianstvo" name="A_001_013_Obcianstvo" class="input-xlarge"> <option>Ruská federácia</option> <option>Ukrajina</option> <option>Čína</option> <option>Južná Kórea</option> </select> </div> </div> <hr> <!-- Text input--> <div class="control-group"> <label class="control-label" for="A_001_014_Cislo_pasu">Číslo pasu</label> <div class="controls"> <input id="A_001_014_Cislo_pasu" name="A_001_014_Cislo_pasu" type="text" placeholder="Číslo pasu" class="input-xlarge"> <p class="help-block">?</p> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="A_001_015_Datum_vydania">Dátum vydania</label> <div class="controls"> <input id="A_001_015_Datum_vydania" name="A_001_015_Datum_vydania" type="text" placeholder="Dátum vydania" class="input-xlarge"> <p class="help-block">help</p> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="A_001_016_Platnost_do">Koniec platnosti pasu:</label> <div class="controls"> <input id="A_001_016_Platnost_do" name="A_001_016_Platnost_do" type="text" placeholder="DD/MM/YYYY" class="input-xlarge"> <p class="help-block">?</p> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="A_001_017_Vydany_kym">Vydaný kým?</label> <div class="controls"> <input id="A_001_017_Vydany_kym" name="A_001_017_Vydany_kym" type="text" placeholder="Vydaný kým?" class="input-xlarge"> <p class="help-block">?</p> </div> </div> </fieldset> </form> <!-- Button (Double) --> <div class="control-group"> <label class="control-label" for="dalej"></label> <div class="controls"> <button id="dalej" name="dalej" class="btn btn-danger">Späť</button> <button id="spat" name="spat" class="btn btn-success">Ďalej</button> </div> </div> </fieldset> </form> </div> </div>

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