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"Formato Captura"
Bootstrap 2.3.2 Snippet by
alviore
2.3.2
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<link href="//netdna.bootstrapcdn.com/twitter-bootstrap/2.3.2/css/bootstrap-combined.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//netdna.bootstrapcdn.com/twitter-bootstrap/2.3.2/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>Formato para perfil de cliente</legend> <!-- Text input--> <div class="control-group"> <label class="control-label" for="name">Nombre</label> <div class="controls"> <input id="name" name="name" type="text" placeholder="" class="input-xlarge" required=""> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="last">Apellidos</label> <div class="controls"> <input id="last" name="last" type="text" placeholder="" class="input-xlarge" required=""> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="phone">Teléfono</label> <div class="controls"> <input id="phone" name="phone" type="text" placeholder="" class="input-xlarge" required=""> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="mail">Correo Electrónico</label> <div class="controls"> <input id="mail" name="mail" type="text" placeholder="" class="input-xlarge" required=""> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="email">Confirmar correo</label> <div class="controls"> <input id="email" name="email" type="text" placeholder="" class="input-xlarge" required=""> </div> </div> <!-- Text input--> <div class="control-group"> <label class="control-label" for="empresa">Nombre o Razón Social</label> <div class="controls"> <input id="empresa" name="empresa" type="text" placeholder="" class="input-xlarge" required=""> </div> </div> <!-- Select Basic --> <div class="control-group"> <label class="control-label" for="facturas">Número de facturas que emite por mes</label> <div class="controls"> <select id="facturas" name="facturas" class="input-xlarge"> <option>Seleccione una opción</option> <option>1 a 20</option> <option>21 a 50</option> <option>51 a 100</option> <option>101 a 300</option> <option>301 a 500</option> <option>Más de 500</option> </select> </div> </div> <!-- Select Basic --> <div class="control-group"> <label class="control-label" for="giro">Identifique el giro que va de acuerdo a su empresa</label> <div class="controls"> <select id="giro" name="giro" class="input-xlarge"> <option>Seleccione una opción</option> <option>Arrendamiento de Inmuebles</option> <option>Blindaje</option> <option>Cheques de Viajero</option> <option>Comercio Exterior</option> <option>Donativos</option> <option>Fedatarios Públicos</option> <option>Inmuebles</option> <option>Juegos y Sorteos</option> <option>Metales y Joyas</option> <option>Mutuo, Préstamo o Crédito</option> <option>Obras de Arte</option> <option>Servicios Profesionales</option> <option>Tarjetas de Devolución y Recompensas</option> <option>Tarjetas de Prepago y Cupones</option> <option>Tarjetas de Servicio y Crédito</option> <option>Traslado o Custodia de Valores</option> <option>Vehículos</option> </select> </div> </div> <!-- Button --> <div class="control-group"> <label class="control-label" for="send"></label> <div class="controls"> <button id="send" name="send" class="btn btn-primary">Guardar y Enviar</button> </div> </div> </fieldset> </form>
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