Update enter_information.php

[clinton/MarylandElectronicPetitionSignature.git] / is_the_information_correct.php

<?PHP include_once('header.php');  ?>

  
 <div class='col-sm-12'>is this information correct </div>
  
  <div class='col-sm-6'>First Name </div><div class='col-sm-6'>Bob</div>
  
  <div class='col-sm-6'>Middle Name </div><div class='col-sm-6'>Edward</div>
  
  <div class='col-sm-6'>Last Name </div><div class='col-sm-6'>Smith</div>
  
  <div class='col-sm-6'>Full Addresss </div><div class='col-sm-6'>1232 Roadly Ct.</div>
  
  <div class='col-sm-2'>City</div><div class='col-sm-2'>Baltimore</div>
  <div class='col-sm-2'>County</div><div class='col-sm-2'>Baltimore City</div>
  <div class='col-sm-2'>Zip</div><div class='col-sm-2'>21204</div>

  
  <div class='col-sm-6'><button type="button" class="btn btn-success">YES</button> </div>
  
  <div class='col-sm-6'><button type="button" class="btn btn-danger">NO</button>  </div>
  
  
  
  
  
  
  


<?PHP include_once('footer.php');