<div class='row'>
                <div class='col-md-4 col-sm-6'>
                       {!! Form::numeric('visit_by')
                       -> label(trans('profile::visit.label.visit_by'))
                       -> placeholder(trans('profile::visit.placeholder.visit_by'))!!}
                </div>

                <div class='col-md-4 col-sm-6'>
                       {!! Form::numeric('visit_to')
                       -> label(trans('profile::visit.label.visit_to'))
                       -> placeholder(trans('profile::visit.placeholder.visit_to'))!!}
                </div>

                <div class='col-md-4 col-sm-6'>
                       {!! Form::text('visit_type')
                       -> label(trans('profile::visit.label.visit_type'))
                       -> placeholder(trans('profile::visit.placeholder.visit_type'))!!}
                </div>

                <div class='col-md-4 col-sm-6'>
                    <div class='form-group'>
                        <label for='visit_date' class='control-label'>{!!trans('profile::visit.label.visit_date')!!}</label>
                        <div class='input-group pickdatetime'>
                            {!! Form::text('visit_date')
                            -> placeholder(trans('profile::visit.placeholder.visit_date'))
                            -> addClass('pickdatetime')
                            ->raw()!!}
                           <span class='input-group-addon'><i class='fa fa-calendar'></i></span>
                        </div>
                    </div>
                 </div>
            </div>