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<!DOCTYPE html> <html> <head> <title>Title of the document</title> <style> div { margin-bottom: 10px; } label { display: inline-block; width: 120px; } fieldset { background: #e1eff2; } legend { padding: 20px 0; font-size: 22px; } </style> </head> <body> <form> <fieldset disabled> <legend>Personal Information:</legend> <div> <label>First Name:</label> <input type="text"> </div> <div> <label>Last Name:</label> <input type="text"> </div> <div> <label>Date of birth:</label> <input type="text"> </div> </fieldset> </form> </body> </html>