<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"> <div class="col-sm-6"> <div class="panel panel-default panel-sm"> <div class="panel-heading">Add New Lab</div> <div class="panel-body"> <form class="form-horizontal" role="form"> <div class="form-group"> <label class="control-label col-sm-2" for="kind">Kind:</label> <div class="col-sm-10"> <input type="text" class="form-control" id="Kind" placeholder="Hemoglobin or Choresterol or....."> </div> </div> <a href="#" class="btn btn-primary" role="button">Attachement</a> <a href="#" class="btn btn-primary" role="button">Save</a> </form> </div> </div> <div class="panel panel-default panel-sm"> <div class="panel-heading">Allergies</div> <div class="panel-body"> <form class="form-horizontal" role="form"> <div class="form-group"> <label class="control-label col-sm-2" for="Allergies">Allergy:</label> <div class="col-sm-10"> <input type="text" class="form-control" id="Allergy" placeholder="Allergy Name"> </div> </div> <div class="form-group"> <label class="control-label col-sm-2" for="desc">Description:</label> <div class="col-sm-10"> <input type="text" class="form-control" id="desc" placeholder="Enter specific reaction here..."> </div> </div> <div class="form-group"> <label class="control-label col-sm-2" for="note">Note:</label> <div class="col-sm-10"> <input type="text" class="form-control" id="note" placeholder=""> </div> </div> <a href="#" class="btn btn-primary" role="button">Attachement</a> <a href="#" class="btn btn-primary" role="button">Save</a> </form> </div> </div> <div class="panel panel-default panel-sm"> <div class="panel-heading">Add New Image</div> <div class="panel-body"> <form class="form-horizontal" role="form"> <div class="form-group"> <label class="control-label col-sm-2">Kind:</label> <div class="col-sm-10"> <input type="text" class="form-control" id="kind" placeholder="Ex:X-ray..."> </div> </div> <div class="form-group"> <label class="control-label col-sm-2">Date:</label> <div class="col-sm-10"> <input type="text" class="form-control" id="date" placeholder=""> </div> </div> <div class="form-group"> <label class="control-label col-sm-2">Results:</label> <div class="col-sm-10"> <input type="text" class="form-control" id="result" placeholder=""> </div> </div> <a href="#" class="btn btn-primary" role="button">Attachement</a> <a href="#" class="btn btn-primary" role="button">Save</a> </form> </div> </div> <div class="panel panel-default panel-sm"> <div class="panel-heading">Add New Family History</div> <div class="panel-body"> <form class="form-horizontal" role="form"> <div class="form-group"> <label class="control-label col-sm-2">Relationship:</label> <div class="col-sm-10"> <input type="text" class="form-control" placeholder=""> </div> </div> <div class="form-group"> <label class="control-label col-sm-2">Description:</label> <div class="col-sm-10"> <input type="text" class="form-control" placeholder="Enter specific condition here..."> </div> </div> <div class="form-group"> <label class="control-label col-sm-2">Note:</label> <div class="col-sm-10"> <input type="text" class="form-control" placeholder=""> </div> </div> <a href="#" class="btn btn-primary" role="button">Attachement</a> <a href="#" class="btn btn-primary" role="button">Save</a> </form> </div> </div> </div> </div> </div> </div> </body>