<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><center>User Service Request Details</center></legend> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="requestid">Request ID</label> <div class="col-md-4"> <input id="requestid" name="reqid" placeholder="Request Id" class="form-control input-md" required="" type="text"> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="declineType">Issue Type</label> <div class="col-md-4"> <select id="issuetype" name="issuetype" class="form-control"> <option value="l">Blumber</option> <option value="2">Electrician</option> </select> </div> </div> <!-- Textarea --> <div class="form-group"> <label class="col-md-4 control-label" for="dis">Discriptions</label> <div class="col-md-4"> <textarea class="form-control" id="dis" name="dis"></textarea> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="date">Created At</label> <div class="col-md-4"> <input id="date" name="date" placeholder="Date" class="form-control input-md" type="text"> </div> </div> <!-- Button --> <div class="form-group"> <label class="col-md-4 control-label" for="submit"></label><center> <div class="col-md-4"> <button id="submit" name="submit" class="btn btn-default">Submit</button> </div></center> </div> </fieldset> </form> </div> </div>