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@tiagorigoletto
Created January 27, 2014 16:56
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<!doctype html>
<html lang="en">
<head>
<meta charset="UTF-8">
<title>Document</title>
<link href="assets/css/dist/css/bootstrap.min.css" rel="stylesheet" type="text/css">
<link href="assets/css/dist/css/bootstrap-theme.min.css" rel="stylesheet" type="text/css">
<link href="assets/css/stylesheet.css" rel="stylesheet" type="text/css">
<script src="assets/js/jquery-1.10.2.min.js" type="text/javascript"></script>
<script src="assets/css/dist/js/bootstrap.min.js" type="text/javascript"></script>
</head>
<body>
<div id="site">
<!-- Navbar -->
<div class="navbar navbar-default navbar-static-top" role="navigation">
<div class="container">
<div class="navbar-header">
<a href="index.html" class="navbar-brand">DNE</a>
</div>
<div class="navbar-collapse collapse">
<ul class="nav navbar-nav pull-right">
<li>
<a href="index.html">Início</a>
</li>
<li>
<a href="#" class="dropdown-toggle" data-toggle="dropdown">Meu DNE <span class="caret"></span></a>
<ul class="dropdown-menu" role="menu">
<li><a href="#">Solicitar DNE</a></li>
<li><a href="#">Solicitar Segunda via</a></li>
<li><a href="#">Minhas Solicitações</a></li>
</ul>
</li>
<li>
<a href="#" class="dropdown-toggle" data-toggle="dropdown">Minha conta <span class="caret"></span></a>
<ul class="dropdown-menu" role="menu">
<li><a href="#">Alterar e-mail</a></li>
<li><a href="#">Alterar senha</a></li>
<li><a href="#">Sair</a></li>
</ul>
</li>
</ul>
</div>
</div>
</div>
<!-- # Navbar # -->
<div class="container">
<div class="row">
<h3 class="pull-left">Confirme os dados de sua solicitação</h3>
</div>
<table class="table solicitacoes">
<thead>
<tr>
<th class="text-left" colspan="3">Dados pessoais</th>
</tr>
</thead>
<tbody>
<tr>
<td class="text-right row-label">Nome:</td>
<td class="text-left">Tiago Rigoletto</td>
<td class="text-right row-label">Data de nascimento:</td>
<td class="text-left">25/10/1987</td>
</tr>
<tr>
<td class="text-right row-label">Nível de escolaridade:</td>
<td class="text-left">Pós-graduação</td>
<td class="text-right row-label">Número de telefone:</td>
<td class="text-left">(xx) 0011-2233</td>
</tr>
<tr>
<td class="text-right row-label">Celular:</td>
<td class="text-left">(xx) 0011-2233</td>
<td class="text-right row-label">Documento de identificação:</td>
<td class="text-left">RG</td>
</tr>
<tr>
<td class="text-right row-label">Número do documento:</td>
<td class="text-left">00.111.222-3</td>
<td class="text-right row-label">Orgão expedidor:</td>
<td class="text-left">SSP</td>
</tr>
<tr>
<td class="text-right row-label">Nome da mãe:</td>
<td class="text-left">Maria Leopoldina</td>
<td class="text-right row-label">CPF:</td>
<td class="text-left">000.111.222-33</td>
</tr>
<tr>
<td class="text-right row-label">CEP:</td>
<td class="text-left">00111-222</td>
<td class="text-right row-label">Endereço:</td>
<td class="text-left">Rua Barão de Iguape</td>
</tr>
<tr>
<td class="text-right row-label">Número:</td>
<td class="text-left">123</td>
<td class="text-right row-label">Complemento:</td>
<td class="text-left">apto 46</td>
</tr>
<tr>
<td class="text-right row-label">Cidade:</td>
<td class="text-left">São Paulo</td>
<td class="text-right row-label">Estado:</td>
<td class="text-left">São Paulo</td>
</tr>
</tbody>
<thead>
<tr>
<th class="text-left" colspan="3">Dados pessoais</th>
</tr>
</thead>
<tbody>
<tr>
<td class="text-right row-label">Estado onde estuda:</td>
<td class="text-left">Minas Gerais</td>
<td class="text-right row-label">Cidade onde estuda:</td>
<td class="text-left">Belo Horizonte</td>
</tr>
<tr>
<td class="text-right row-label">Nome da instituição:</td>
<td class="text-left">Pontifícia Universidade Católica</td>
<td class="text-right row-label">Curso:</td>
<td class="text-left">Design de Interação</td>
</tr>
<tr>
<td class="text-right row-label">Série:</td>
<td class="text-left">3</td>
<td class="text-right row-label">Período:</td>
<td class="text-left">Manhã</td>
</tr>
<tr>
<td class="text-right row-label">Número da matrícula:</td>
<td class="text-left">2345678</td>
<td class="text-right row-label"></td>
<td class="text-left"></td>
</tr>
</tbody>
<thead>
<tr>
<th class="text-left" colspan="3">Dados do DNE</th>
</tr>
</thead>
<tbody>
<tr>
<td class="text-right row-label">Carteirinha:</td>
<td class="text-left">Carteirinha DCE PUC-MG</td>
<td class="text-right row-label">Valor:</td>
<td class="text-left">R$ 50,00</td>
</tr>
</tbody>
</table>
<button class="btn btn-primary pull-right">Confirmar pedido</button>
</div>
</div>
</body>
</html>
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