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user_registration.html
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<!DOCTYPE html>
<head>
<title>Test</title>
<meta charset="utf-16">
<link rel="stylesheet" type="text/css" href="main.css">
<meta name="viewport" content="width=device-width, initial-scale=1">
<link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.7/css/bootstrap.min.css">
<script src="https://ajax.googleapis.com/ajax/libs/jquery/1.12.4/jquery.min.js"></script>
<script src="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.7/js/bootstrap.min.js"></script>
<!-- Custom styles for this template -->
<link href="user_registration.css" rel="stylesheet">
</head>
<body>
<div class="site-wrapper-inner">
<div class="cover-container">
<div class="masthead clearfix">
<div class="inner">
<a href='user_home.html'>
<img src='logo11.png' class="masthead-brand">
</a>
<nav>
<!--<ul class="nav masthead-nav">
<li class="active"><a href="#">Home</a></li>
<li><a href="#">Features</a></li>
<li><a href="#">Contact</a></li>
</ul>-->
</nav>
</div>
</div>
</div>
</div>
<form class="form-horizontal">
<fieldset>
<div class="page-header">
<h1>Φορμα Δηλωσης Ατυχηματος</h1>
</div>
<!-- Text input-->
<div class="form-group">
<label class="col-md-4 control-label" for="nama">Αριθμός Κυκλοφορίας</label>
<div class="col-md-4">
<input id="nama" name="nama" type="text" placeholder="Αριθμός Κυκλοφορίας" class="form-control input-md">
<span class="help-block">Εισάγετε τον αριθμό κυκλοφορίας του αυτοκινήτου</span>
</div>
</div>
<!-- Text input-->
<div class="form-group">
<label class="col-md-4 control-label" for="nama">Ονοματεπώνυμο</label>
<div class="col-md-4">
<input id="nama" name="nama" type="text" placeholder="Ονοματεπώνυμο" class="form-control input-md">
<span class="help-block">Εισάγετε το όνομα στο οποίο είναι ασφαλισμένο το αυτοκίνητο</span>
</div>
</div>
<ul class="row">
<li class="col-md-3 col-md-offset-3">
<!-- Select Basic -->
<div class="form-group">
<label class="col-md-4 control-label" for="nama">Μάρκα Αυτοκινήτου</label>
<div class="col-md-4">
<input id="nama" name="nama" type="text" placeholder="Μάρκα Αυτοκινήτου" class="form-control input-md">
</div>
</div>
</li>
<li class="col-md-3">
<!-- Select Basic -->
<div class="form-group">
<label class="col-md-4 control-label" for="nama">Μοντέλο Αυτοκινήτου</label>
<div class="col-md-4">
<input id="nama" name="nama" type="text" placeholder="Μοντέλο Αυτοκινήτου" class="form-control input-md">
</div>
</div>
</li>
<li class="col-md-3">
<!-- Select Basic -->
<div class="form-group">
<label class="col-md-4 control-label" for="nama">Έτος Κυκλοφορίας</label>
<div class="col-md-4">
<input id="nama" name="nama" type="text" placeholder="Έτος Κυκλοφορίας" class="form-control input-md">
</div>
</div>
</li>
</ul>
<!-- File Button -->
<div class="form-group">
<label class="col-md-4 control-label" for="pas foto">pas foto</label>
<div class="col-md-4">
<input id="pas foto" name="pas foto" class="input-file" type="file">
</div>
</div>
<!-- Textarea -->
<div class="form-group">
<label class="col-md-4 control-label" for="Alamat tinggal">Περιγραφή ατυχήματος</label>
<div class="col-md-4">
<textarea class="form-control" id="Alamat tinggal" name="Alamat tinggal">Περιγραφή...</textarea>
</div>
</div>
<!--
File Button
<div class="form-group">
<label class="col-md-4 control-label" for="KTP">KTP</label>
<div class="col-md-4">
<input id="KTP" name="KTP" class="input-file" type="file">
</div>
</div>
File Button
<div class="form-group">
<label class="col-md-4 control-label" for="SIM">SIM</label>
<div class="col-md-4">
<input id="SIM" name="SIM" class="input-file" type="file">
</div>
</div>
File Button
<div class="form-group">
<label class="col-md-4 control-label" for="STNK">STNK</label>
<div class="col-md-4">
<input id="STNK" name="STNK" class="input-file" type="file">
</div>
</div>
-->
<!-- Button -->
<div class="form-group">
<label class="col-md-4 control-label" for="submit">Submit</label>
<div class="col-md-4">
<button id="submit" name="submit" class="btn btn-success">Submit</button>
</div>
</div>
</fieldset>
</form>
</body>