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<form id="evidence-form" class="form-horizontal">
<fieldset>
<fieldset>
<legend>BEL Statement</legend>
<div class="form-group">
<label class="col-md-4 control-label" for="bel-statement"></label>
<div class="col-md-8">
<input id="bel-statement" name="bel-statement" placeholder="Subject Relationship Object" class="form-control input-md" required="" type="text">
<span class="help-block">i.e. p(HGNC:AKT1) -> bp(MESHPP:Apoptosis)</span>
</div>
</div>
</fieldset>
<fieldset>
<legend>Citation</legend>
<div class="form-group">
<label class="col-md-4 control-label" for="citation-pubmed-id">PubMed ID</label>
<div class="col-md-8">
<input id="citation-pubmed-id" name="citation-pubmed-id" placeholder="PubMed identifier" class="form-control input-md" required="" type="text">
<span class="help-block">i.e. 9202001</span>
</div>
<label class="col-md-4 control-label" for="citation-name">Name</label>
<div class="col-md-8">
<input id="citation-name" name="citation-name" placeholder="PubMed reference name" class="form-control input-md" required="" type="text">
<span class="help-block">i.e. J Biol Chem. 1997 Jul 4;272(27):16917-23.</span>
</div>
</div>
</fieldset>
<fieldset>
<legend>Annotation</legend>