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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0, user-scalable=0">
<link rel="shortcut icon" type="image/x-icon" href="assets/img/favicon.ico">
<title>Preclinic - Medical & Hospital - Bootstrap 4 Admin Template</title>
<link rel="stylesheet" type="text/css" href="assets/css/bootstrap.min.css">
<link rel="stylesheet" type="text/css" href="assets/css/font-awesome.min.css">
<link rel="stylesheet" type="text/css" href="assets/css/fullcalendar.min.css">
<link rel="stylesheet" type="text/css" href="assets/css/dataTables.bootstrap4.min.css">
<link rel="stylesheet" type="text/css" href="assets/css/style.css">
<!--[if lt IE 9]>
<script src="assets/js/html5shiv.min.js"></script>
<script src="assets/js/respond.min.js"></script>
<![endif]-->
</head>
<body>
<div class="content">
<div class="row">
<div class="col-sm-12">
<h4 class="page-title">Vertical Form</h4>
</div>
</div>
<div class="row">
<div class="col-md-6">
<div class="card-box">
<h4 class="card-title">Basic Form</h4>
<form action="#">
<div class="form-group">
<label>First Name</label>
<input type="text" class="form-control">
</div>
<div class="form-group">
<label>Last Name</label>
<input type="text" class="form-control">
</div>
<div class="form-group">
<label>Email Address</label>
<input type="email" class="form-control">
</div>
<div class="form-group">
<label>Username</label>
<input type="text" class="form-control">
</div>
<div class="form-group">
<label>Password</label>
<input type="password" class="form-control">
</div>
<div class="form-group">
<label>Repeat Password</label>
<input type="password" class="form-control">
</div>
<div class="text-right">
<button type="submit" class="btn btn-primary">Submit</button>
</div>
</form>
</div>
</div>
<div class="col-md-6">
<div class="card-box">
<h4 class="card-title">Address Form</h4>
<form action="#">
<div class="form-group">
<label>Address Line 1</label>
<input type="text" class="form-control">
</div>
<div class="form-group">
<label>Address Line 2</label>
<input type="text" class="form-control">
</div>
<div class="form-group">
<label>City</label>
<input type="text" class="form-control">
</div>
<div class="form-group">
<label>State</label>
<input type="text" class="form-control">
</div>
<div class="form-group">
<label>Country</label>
<input type="text" class="form-control">
</div>
<div class="form-group">
<label>Postal Code</label>
<input type="text" class="form-control">
</div>
<div class="text-right">
<button type="submit" class="btn btn-primary">Submit</button>
</div>
</form>
</div>
</div>
</div>
<div class="row">
<div class="col-md-12">
<div class="card-box">
<h4 class="card-title">Two Column Vertical Form</h4>
<form action="#">
<h4 class="card-title">Personal Information</h4>
<div class="row">
<div class="col-md-6">
<div class="form-group">
<label>First Name</label>
<input type="text" class="form-control">
</div>
<div class="form-group">
<label>Last Name</label>
<input type="text" class="form-control">
</div>
<div class="form-group">
<label>Blood Group</label>
<select class="select">
<option>Select</option>
<option value="1">A+</option>
<option value="2">O+</option>
<option value="3">B+</option>
<option value="4">AB+</option>
</select>
</div>
<div class="form-group">
<label class="display-block">Gender:</label>
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" name="gender" id="gender_male" value="option1">
<label class="form-check-label" for="gender_male">Male</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" name="gender" id="gender_female" value="option2">
<label class="form-check-label" for="gender_female">Female</label>
</div>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>Username</label>
<input type="text" class="form-control">
</div>
<div class="form-group">
<label>Email</label>
<input type="text" class="form-control">
</div>
<div class="form-group">
<label>Password</label>
<input type="text" class="form-control">
</div>
<div class="form-group">
<label>Repeat Password</label>
<input type="text" class="form-control">
</div>
</div>
</div>
<h4 class="card-title">Postal Address</h4>
<div class="row">
<div class="col-md-6">
<div class="form-group">
<label>Address Line 1</label>
<input type="text" class="form-control">
</div>
<div class="form-group">
<label>Address Line 2</label>
<input type="text" class="form-control">
</div>
<div class="form-group">
<label>State</label>
<input type="text" class="form-control">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>City</label>
<input type="text" class="form-control">
</div>
<div class="form-group">
<label>Country</label>
<input type="text" class="form-control">
</div>
<div class="form-group">
<label>Postal Code</label>
<input type="text" class="form-control">
</div>
</div>
</div>
<div class="text-right">
<button type="submit" class="btn btn-primary">Submit</button>
</div>
</form>
</div>
</div>
</div>
<div class="row">
<div class="col-md-12">
<form action="#">
<div class="card-box">
<div class="row">
<div class="col-md-6">
<h4 class="card-title">Personal details</h4>
<div class="form-group">
<label>Name:</label>
<input type="text" class="form-control">
</div>
<div class="form-group">
<label>Password:</label>
<input type="password" class="form-control">
</div>
<div class="form-group">
<label>State:</label>
<select class="select">
<option>Select State</option>
<option value="1">California</option>
<option value="2">Texas</option>
<option value="3">Florida</option>
</select>
</div>
<div class="form-group">
<label>Your message:</label>
<textarea rows="5" cols="5" class="form-control" placeholder="Enter message"></textarea>
</div>
</div>
<div class="col-md-6">
<h4 class="card-title">Personal details</h4>
<div class="row">
<div class="col-md-6">
<div class="form-group">
<label>First name:</label>
<input type="text" class="form-control">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>Last name:</label>
<input type="text" class="form-control">
</div>
</div>
</div>
<div class="row">
<div class="col-md-6">
<div class="form-group">
<label>Email:</label>
<input type="text" class="form-control">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>Phone:</label>
<input type="text" class="form-control">
</div>
</div>
</div>
<div class="row">
<div class="col-md-12">
<div class="form-group">
<label>Address line:</label>
<input type="text" class="form-control">
</div>
</div>
</div>
<div class="row">
<div class="col-md-6">
<div class="form-group">
<label>Country:</label>
<select class="select">
<option>Select Country</option>
<option value="1">USA</option>
<option value="2">France</option>
<option value="3">India</option>
<option value="4">Spain</option>
</select>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>State/Province:</label>
<input type="text" class="form-control">
</div>
</div>
</div>
<div class="row">
<div class="col-md-6">
<div class="form-group">
<label>ZIP code:</label>
<input type="text" class="form-control">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>City:</label>
<input type="text" class="form-control">
</div>
</div>
</div>
</div>
</div>
<div class="text-right">
<button type="submit" class="btn btn-primary">Submit</button>
</div>
</div>
</form>
</div>
</div>
</div>
<div class="sidebar-overlay" data-reff=""></div>
<script src="assets/js/jquery-3.2.1.min.js"></script>
<script src="assets/js/popper.min.js"></script>
<script src="assets/js/bootstrap.min.js"></script>
<script src="assets/js/jquery.slimscroll.js"></script>
<script src="assets/js/app.js"></script>
</body>
</html>
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