<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>
<div class="panel-body">
<div class="form-group">
<div class="col-md-12">
<h4>Shipping Address</h4>
</div>
</div>
<div class="form-group">
<div class="col-md-6 col-xs-12">
<strong>First Name:</strong>
<input type="text" name="first_name" class="form-control" value="" />
</div>
<div class="span1"></div>
<div class="col-md-6 col-xs-12">
<strong>Last Name:</strong>
<input type="text" name="last_name" class="form-control" value="" />
</div>
</div>
<div class="form-group">
<div class="col-md-12"><strong>Address:</strong></div>
<div class="col-md-12">
<input type="text" name="address" class="form-control" value="" />
</div>
</div>
<div class="form-group">
<div class="col-md-6 col-xs-12">
<strong>Country:</strong>
<input type="text" name="country" class="form-control" value="" />
</div>
<div class="span1"></div>
<div class="col-md-6 col-xs-12">
