diff --git a/providerwww/application/views/provider/patient/newpatient.php b/providerwww/application/views/provider/patient/newpatient.php
index 0e86ba2..2b41187 100644
--- a/providerwww/application/views/provider/patient/newpatient.php
+++ b/providerwww/application/views/provider/patient/newpatient.php
@@ -31,6 +31,17 @@
                             
                             <div class="card-body">
                                 <form>
+                                     <div class="form-row">
+                                        <div class="form-group col-md-6">
+                                            <label for="inputEmail4">Firstname</label>
+                                            <input type="text" class="form-control" id="firstname" placeholder="Firstname">
+                                        </div>
+                                        <div class="form-group col-md-6">
+                                            <label for="inputPassword4">Lastname</label>
+                                            <input type="text" class="form-control" id="lastname" placeholder="Lastname">
+                                        </div>
+                                    </div>
+                                    
                                     <div class="form-row">
                                         <div class="form-group col-md-6">
                                             <label for="inputEmail4">Email</label>