="form-group">
                      <input type="text" name="d_26" class="form-control" placeholder="26"/>
                  </div>
              </div>
              <div class="form-inline">
                <div class="form-group">
                    <input type="text" name="d_46" class="form-control" placeholder="46"/>
                </div>
                <div class="form-group">
                    <input type="text" name="d_31" class="form-control" placeholder="31"/>
                </div>
        