<link href="//netdna.bootstrapcdn.com/bootstrap/3.0.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css">
<script src="//netdna.bootstrapcdn.com/bootstrap/3.0.0/js/bootstrap.min.js"></script>
<script src="//code.jquery.com/jquery-1.11.1.min.js"></script>
<div class="container">
<div class="row">
<div class="col-lg-4 col-md-4 col-sm-12">
<label class='control-label'>Boleta</label>
<input type="text" class="form-control" aria-label="...">
</div>
<div class="col-lg-4 col-md-4 col-sm-12">
<label class='control-label'>Referencia</label>
<input type="text" class="form-control" aria-label="...">
</div>
<div class="col-lg-4 col-md-4 col-sm-12">
<label class='control-label'>Asunto</label>
<input type="text" class="form-control" aria-label="...">
</div>
</div>
<div class="row">
<div class="col-lg-6 col-md-6 col-sm-12">
<label class='control-label'>Fecha Inicial</label>
<div class="input-group">
<input type="text" class="form-control" aria-describedby="basic-addon2">
<span class="input-group-addon" id="basic-addon2"><span class=" glyphicon glyphicon-calendar"></span></span></span>
</div>
</div>
<div class="col-lg-6 col-md-6 col-sm-12">
<label class='control-label'>Fecha final</label>
<div class="input-group">
<input type="text" class="form-control" aria-describedby="basic-addon2">
<span class="input-group-addon" id="basic-addon2"><span class=" glyphicon glyphicon-calendar"></span></span></span>
</div>
</div>
</div>
