<div class="row">
	<div class="col-md-12">
		<div class="rent-details-box">
			<div class="rent-details-item">
				<label> Full Name </label>
				[text fname id:fname class:form-control placeholder"Enter Full Name"]
				</div>

				<div class="rent-details-item">
				<label> Mobile No </label>
				[text phone id:phone class:form-control placeholder"Enter Phone no."]
				</div>

				<div class="rent-details-item">
				<label> Pickup Location </label>
				[text pickup-location id:pickuplocation class:form-control placeholder"Enter Location"]
				</div>

				<div class="rent-details-item">
				<label> Pickup Date </label>
				[date date id:date class:form-control placeholder "Date"]
				</div>

				<div class="rent-details-item rent-details-search">
				[submit id:msgSubmit class:form-btn "Send"]
				</div>
		</div>
	</div>
</div>