 </div>
            </div>
          </div>
          <!--/.row-->
          <div class="row">
            <div class="col-sm-12">
              <div class="form-group">
                <label for="ccnumber">Credit Card Number</label>
                <input type="text" class="form-control" id="ccnumber" placeholder="0000 0000 0000 0000">
              </div>
            </div>
          </div>
          <!--/.row-->
          <div class="row">
            <div class="form-group col-sm-4">
              <lab