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"bimar form"
Bootstrap 4.1.1 Snippet by
niloo
4.1.1
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<link href="//maxcdn.bootstrapcdn.com/bootstrap/4.1.1/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//maxcdn.bootstrapcdn.com/bootstrap/4.1.1/js/bootstrap.min.js"></script> <script src="//cdnjs.cloudflare.com/ajax/libs/jquery/3.2.1/jquery.min.js"></script> <!------ Include the above in your HEAD tag ----------> <form class="form-horizontal"> <fieldset> <!-- Form Name --> <p align="right"><b> <font face="B nazanin"> <legend>معرفی بیمار</legend> </b></p> <!-- Text input--> <div class="form-group"> <p align="right"><b> <font face="B nazanin"> <label class="col-md-4 control-label" for="textinput">نام</label> <div class="col-md-4"> <input id="textinput" name="textinput" type="text" placeholder="نام خود را وارد کنید" class="form-control input-md" required=""> </b></p> </div> </div> <!-- Text input--> <div class="form-group"> <p align="right"><b> <font face="B nazanin"> <label class="col-md-4 control-label" for="textinput">نام خانوادگی</label> <div class="col-md-4"> <input id="textinput" name="textinput" type="text" placeholder="نام خانوادگی خود را وارد کنید" class="form-control input-md" required=""> </b></p> </div> </div> <!-- Text input--> <div class="form-group"> <p align="right"><b> <font face="B nazanin"> <label class="col-md-4 control-label" for="textinput">کد ملی</label> <div class="col-md-4"> <input id="textinput" name="textinput" type="text" placeholder="کد ملی خود را وارد کنید" class="form-control input-md" required=""> </b></p> </div> </div> <!-- Text input--> <div class="form-group"> <p align="right"><b> <font face="B nazanin"> <label class="col-md-4 control-label" for="textinput">تلفن همراه</label> <div class="col-md-4"> <input id="textinput" name="textinput" type="text" placeholder="تلفن همراه خود را وارد کنید" class="form-control input-md" required=""> </b></p> </div> </div> <!-- Select Basic --> <div class="form-group"> <p align="right"><b> <font face="B nazanin"> <label class="col-md-4 control-label" for="selectbasic">وقت خود را انتخاب کنید</label> <div class="col-md-4"> <select id="selectbasic" name="selectbasic" class="form-control"> <option value="1">شنبه صبح ساعت 09:00</option> <option value="2">یک شنبه صبح ساعت 10:00</option> <option value="3">دوشنبه عصر ساعت 16:00</option> </select> </b></p> </div> </div> <!-- Button --> <div class="form-group"> <label class="col-md-4 control-label" for="singlebutton"></label> <div class="col-md-4"> <button id="singlebutton" name="singlebutton" class="btn btn-primary">ثبت نوبت</button> </div> </div> </fieldset> </form>
.form-horizontal * { direction: rtl; }
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