Skip to content

Instantly share code, notes, and snippets.

@tesfayegari
Last active October 26, 2019 16:33
Show Gist options
  • Save tesfayegari/d4ae24d5515c6a3cc9d72b7ff742368f to your computer and use it in GitHub Desktop.
Save tesfayegari/d4ae24d5515c6a3cc9d72b7ff742368f to your computer and use it in GitHub Desktop.
<div className="container">
<h2>Purchase Order Item form</h2>
<div className="row">
<div className="col-md-6">
<div className="form-group">
<label>Title:</label>
<input type="text" className="form-control" placeholder="Enter Title" name="Title" />
</div>
</div>
<div className="col-md-6">
<div className="form-group">
<label >Full Name:</label>
<input type="text" className="form-control" placeholder="Enter Full Name" name="fullName" />
</div>
</div>
</div>
<div className="row">
<div className="col-md-9">
<div className="form-group">
<label >Street Address:</label>
<input type="text" className="form-control" placeholder="123 Main Street" name="street" />
</div>
</div>
<div className="col-md-3">
<div className="form-group">
<label >Appartment/Room #:</label>
<input type="text" className="form-control" placeholder="Appartment #" name="Appartment" />
</div>
</div>
</div>
<div className="row">
<div className="col-md-4">
<div className="form-group">
<label >City:</label>
<input type="text" className="form-control" placeholder="Enter City" name="city" />
</div>
</div>
<div className="col-md-4">
<div className="form-group">
<label >State:</label>
<select className="form-control" name="state">
<option value="">Select State --</option>
</select>
</div>
</div>
<div className="col-md-4">
<div className="form-group">
<label>Zip Code:</label>
<input type="text" className="form-control" placeholder="Zip Code" name="zip" />
</div>
</div>
</div>
<div className="row">
<div className="col-md-12">
<div className="checkbox">
<label><input type="checkbox" name="remember" checked /> Is Billing Address Same</label>
</div>
</div>
<div className="col-md-12 hidden">
<div className="form-group">
<label >Billing Address:</label>
<textarea className="form-control" rows={3} name="billing" placeholder="Billing Address"></textarea>
</div>
</div>
<div className="col-sm-12">
<button type="submit" className="btn btn-primary float-right">Submit</button>
<button type="submit" className="btn btn-secondary float-right">Cancel</button>
</div>
</div>
</div>
Sign up for free to join this conversation on GitHub. Already have an account? Sign in to comment