Form

<form action="" method="">
<fieldset>

        <div class="row"><label for="fname">First Name</label>
        <input type="text" class="" value="" id="fname" name="cardholder_first_name"></div>

        <div class="row"><label for="sname">Last Name</label>
        <input type="text" class="" value="" id="sname" name="cardholder_last_name"></div>

        <div class="row"><label for="personal-email">Email</label>
        <input type="text" class="" value="" id="personal-email" name="cardholder_email"></div>

        <div class="row"><label for="phone-no">Phone number</label>
        <input type="tel" class="" value="" id="phone-no" name="cardholder_phone_number"></div>


        <div class="row dob">
                <label for="dob_day">Date of Birth:</label>
                <select class="" name="dob_day">
                        <option value="">Day</option>
                        <option value="1">1</option>
                </select>
        </div>

</fieldset>
</form>