personal-details.html

<div class="container">
    <form action="action_page.php">
      <div class="row">
        <div class="col-25">
          <label for="fname">First Name</label>
        </div>
        <div class="col-75">
          <input type="text" id="fname" name="firstname" placeholder="Your name..">
        </div>
      </div>
      <div class="row">
        <div class="col-25">
          <label for="lname">Last Name</label>
        </div>
        <div class="col-75">
          <input type="text" id="lname" name="lastname" placeholder="Your last name..">
        </div>
      </div>
      <div class="row">
        <div class="col-25">
          <label for="country">Country</label>
        </div>
        <div class="col-75">
          <select id="country" name="country">
            <option value="australia">Australia</option>
            <option value="canada">Canada</option>
            <option value="usa">USA</option>
            <option value="India">India</option>
          </select>
        </div>
        <div class="row">
            <div class="col-25">
              <label for="ucon">User's Contact</label>
            </div>
            <div class="col-75">
              <input type="text" id="ucon" name="lastname" placeholder="User's Contact">
            </div>
      </div>
      <div class="row">
        <div class="col-25">
          <label for="subject"> List of medicines</label>
        </div>
        <div class="col-75">
          <textarea id="subject" name="subject" placeholder="Upload pdf" style="height:200px"></textarea>
        </div>
      </div>
      <div class="row">
        <input type="submit" value="Submit">
      </div>
    </form>
  </div>