<%@ page contentType="text/html; charset=UTF-8"%>
<%@ include file="/WEB-INF/jsp/tag.jsp"%>
<!DOCTYPE html>
<html>
<head>
<link href="http://apps.bdimg.com/libs/bootstrap/3.3.0/css/bootstrap.min.css" rel="stylesheet">
<script src="http://apps.bdimg.com/libs/jquery/2.0.0/jquery.min.js"></script>
<script src="http://apps.bdimg.com/libs/bootstrap/3.3.0/js/bootstrap.min.js"></script>
</head>
<body>
<div class="contianer">
<div class="panel panel-default">
<div class="panel-heading">
<h3 class="panel-title">Jira Form Information</h3>
</div>
<div class="panel-body">
<form class="form-horizontal" action="abc" role="form">
<div class="form-group">
<label for="firstname" class="col-sm-2 control-label">System Code</label>
<div class="col-sm-4">
<input type="text" class="form-control" id="firstname" placeholder="System code">
</div>
</div>
<div class="form-group">
<label for="lastname" class="col-sm-2 control-label">Country Code</label>
<div class="col-sm-4">
<input type="text" class="form-control" id="lastname" placeholder="Country Code">
</div>
</div>
<div class="form-group">
<label for="lastname" class="col-sm-2 control-label">Ingest Frequency</label>
<div class="col-sm-4">
<select class="form-control">
<option>Daily</option>
<option>Monthly</option>
<option>Quarterly</option>
<option>Yearly</option>
<option>Other</option>
</select>
</div>
</div>
<div class="form-group">
<label for="lastname" class="col-sm-2 control-label">Database Platform</label>
<div class="col-sm-4">
<input type="text" class="form-control" id="lastname" placeholder="Database Platform. eg Oracle, DB2">
</div>
</div>
<div class="form-group">
<label for="lastname" class="col-sm-2 control-label">Database Server IPs</label>
<div class="col-sm-4">
<textarea class="form-control" rows="3" placeholder="input database server ips and split by comma ,"></textarea>
</div>
</div>
<div class="form-group">
<label for="lastname" class="col-sm-2 control-label">Database Server Port</label>
<div class="col-sm-4">
<input type="text" class="form-control" id="lastname" placeholder="Database Server Port">
</div>
</div>
<div class="form-group">
<label for="lastname" class="col-sm-2 control-label">Request Types</label>
<div class="col-sm-4">
<label class="checkbox-inline"> <input type="checkbox" id="inlineCheckbox1" value="option1"> AD account
</label> <label class="checkbox-inline"> <input type="checkbox" id="inlineCheckbox2" value="option2"> Ranger and EZ
</label> <label class="checkbox-inline"> <input type="checkbox" id="inlineCheckbox3" value="option3"> FireWall
</label>
<label class="checkbox-inline"> <input type="checkbox" id="inlineCheckbox3" value="option3"> SFTP
</label>
</div>
</div>
<div class="form-group">
<div class="col-sm-offset-2 col-sm-10">
<button type="submit" class="btn btn-default">Submit</button>
</div>
</div>
</form>
</div>
</div>
</div>
</body>
</html>