"Generate Bank Slip - Step 1"
Bootstrap 3.3.0 Snippet by benesoft

<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 ----------> <form class="form-horizontal"> <fieldset> <!-- Form Name --> <legend>Generate Bank Slip (Invoice) - Step 1</legend> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="">Search for client</label> <div class="col-md-6"> <select id="" name="" class="form-control"> <option value="1">Joe Doe</option> <option value="2">John</option> <option value="">Mary</option> </select> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="selectbasic">This Invoice (Bank Slip) If repeated?</label> <div class="col-md-4"> <select id="selectbasic" name="selectbasic" class="form-control"> <option value="1">Yes, Monthly</option> <option value="2">Yes, Bimonthly</option> <option value="">Yes, Quarterly</option> <option value="">Yes, Every Six Months</option> <option value="">Yes, Annually</option> <option value="">unrepeatable</option> </select> </div> </div> <!-- Multiple Radios (inline) --> <div class="form-group"> <label class="col-md-4 control-label" for="radios">Bank slip have a date to end?</label> <div class="col-md-4"> <label class="radio-inline" for="radios-0"> <input type="radio" name="radios" id="radios-0" value="1" checked="checked"> Sim </label> <label class="radio-inline" for="radios-1"> <input type="radio" name="radios" id="radios-1" value="2"> Não </label> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">How many installments?</label> <div class="col-md-4"> <input id="textinput" name="textinput" type="text" placeholder="e.g. 12" class="form-control input-md"> <span class="help-block">How many bank slips will be generated.</span> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">Bank Slip Description</label> <div class="col-md-8"> <input id="textinput" name="textinput" type="text" placeholder="e.g. Hosting Website" class="form-control input-md"> <span class="help-block">Brief description that will be shown on the bank slip</span> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">E-mail Description</label> <div class="col-md-8"> <input id="textinput" name="textinput" type="text" placeholder="" class="form-control input-md"> <span class="help-block">Invoice (bank slip) details such as product or service.</span> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">Slip Bank Amount</label> <div class="col-md-5"> <input id="textinput" name="textinput" type="text" placeholder="0,00" class="form-control input-md"> <span class="help-block">Due date of the invoice to be sent.</span> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="textinput">Due Date</label> <div class="col-md-5"> <input id="textinput" name="textinput" type="text" placeholder="28/02/2016" class="form-control input-md"> <span class="help-block">Due date of the banck slip to be sent.</span> </div> </div> <!-- Button (Double) --> <div class="form-group"> <label class="col-md-4 control-label" for="button1id"></label> <div class="col-md-8"> <button id="button1id" name="button1id" class="btn btn-success">Register</button> <button id="button2id" name="button2id" class="btn btn-danger">Cancel</button> </div> </div> </fieldset> </form>

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