1 <?PHP
include_once('header.php'); ?
>
4 <div
class='col-sm-12'>is this information correct
</div
>
6 <div
class='col-sm-6'>First Name
</div
><div
class='col-sm-6'>Bob
</div
>
8 <div
class='col-sm-6'>Middle Name
</div
><div
class='col-sm-6'>Edward
</div
>
10 <div
class='col-sm-6'>Last Name
</div
><div
class='col-sm-6'>Smith
</div
>
12 <div
class='col-sm-6'>Full Addresss
</div
><div
class='col-sm-6'>1232 Roadly Ct
.</div
>
14 <div
class='col-sm-2'>City
</div
><div
class='col-sm-2'>Baltimore
</div
>
15 <div
class='col-sm-2'>County
</div
><div
class='col-sm-2'>Baltimore City
</div
>
16 <div
class='col-sm-2'>Zip
</div
><div
class='col-sm-2'>21204</div
>
19 <div
class='col-sm-6'><button type
="button" class="btn btn-success">YES
</button
> </div
>
21 <div
class='col-sm-6'><button type
="button" class="btn btn-danger">NO
</button
> </div
>
31 <?PHP
include_once('footer.php');