HTML

Form Elements

<form>
  <label>First Name:</label>
  <input placeholder="Sam" >

  <label>Last Name:</label>
  <input placeholder="Smith" >

  <fieldset disabled>
    <label>City:</label>
    <br>
    <input placeholder="Pune" >
    <br>

    <label>State:</label>
    <br>
    <input placeholder="Maharashtra" >
    <br>

    <label>Country:</label>
    <br>
    <input placeholder="India" >
  </fieldset>
</form>