Get an Appointment Form

<section id="get_an_appointment_section" class="get_appointment_page">
	<div class="get_an_appointment_section">
		<div class="container">
			<div class="row">
				<div class="col-md-7 mx-auto">
					<div class="section_content">
						<div class="appoinment-form">					
            <div class="field--name-field-appointment-form">
            	<form class="contextual-region" method="post" accept-charset="UTF-8">
				<div class="row">
					<div class="col-lg-6">
  						<fieldset class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name form-item-name form-group">
	          				<label for="edit-name" class="js-form-required form-required">Name</label>
	                    	<input data-drupal-selector="edit-name" type="text" id="edit-name" name="name" value="" size="60" maxlength="255" class="form-text required form-control" required="required" aria-required="true">
                      	</fieldset>
					</div>
					<div class="col-lg-6">
  						<fieldset class="js-form-item js-form-type-textfield form-type-textfield js-form-item-contact-no form-item-contact-no form-group">
          					<label for="edit-contact-no">Contact No</label>
                    		<input data-drupal-selector="edit-contact-no" type="text" id="edit-contact-no" name="contact_no" value="" size="60" maxlength="255" class="form-text form-control">
                      	</fieldset>
					</div>
					<div class="col-lg-6">
  						<fieldset class="js-form-item js-form-type-select form-type-select js-form-item-department form-item-department form-group">
          					<label for="edit-department">Department</label>
							<select data-drupal-selector="edit-department" id="edit-department" name="department" class="form-select custom-select"><option value="" selected="selected">- None -</option><option value="Cardiology">Cardialogy</option><option value="Asthma">Asthma</option><option value="Kidney Disease">Kidney Disease</option><option value="Ophthalmology">Ophthalmology</option><option value="Radiology">Radiology</option><option value="Neurological Treatment">Neurological Treatment</option></select>
                      </fieldset>
					</div>
					<div class="col-lg-6">
  						<fieldset class="js-form-item js-form-type-date form-type-date js-form-item-date form-item-date form-group">
          					<label for="edit-date">Date</label>
                    		<input type="date" data-drupal-selector="edit-date" data-drupal-date-format="Y-m-d" id="edit-date" name="date" value="" class="form-date form-control">
                      	</fieldset>
					</div>
					<div class="col-lg-4 ml-auto">
						<div data-drupal-selector="edit-actions" class="form-actions webform-actions js-form-wrapper form-group" id="edit-actions"><button class="webform-button--submit btn-primary-1 button button--primary js-form-submit form-submit btn btn-primary" data-drupal-selector="edit-actions-submit" type="submit" id="edit-actions-submit" name="op" value="Book">Book</button>
					</div>
				</div>     
			</div>
		</form>
	</div>      
						</div>
					</div>
				</div>
			</div><!-- End of row -->
    </div> <!-- end of container -->
</section>