<html lang="en-US">
  <head>
    <meta charset="utf-8">
    <meta name="viewport" content="width=device-width">
    <title>:read-only demo — confirmation form</title>
    <link href="https://fonts.googleapis.com/css?family=Josefin+Sans&display=swap" rel="stylesheet">
  </head>

<body>
    <form>
      <fieldset>
        <legend>Check shipping details</legend>
        <div>
          <label for="name">Name: </label>
          <input id="name" name="name" type="text"
                 value="Mr Soft" readonly>
        </div>
        <div>
          <label for="address">Address: </label>
          <textarea id="address" name="address" readonly>
23 Elastic Way,
Viscous,
Bright Ridge,
CA
</textarea>
        </div>
        <div>
          <label for="pcode">Zip/postal code: </label>
          <input id="pcode" name="pcode" type="text"
                 value="94708" readonly>
        </div>
      </fieldset>

      <fieldset>
        <legend>Final instructions</legend>
        <div>
          <label for="sms-confirm">Send confirmation by SMS?</label>
          <input id="sms-confirm" name="sms-confirm" type="checkbox">
        </div>
        <div>
          <label for="instructions">Any special instructions?</label>
          <textarea id="instructions" name="instructions"></textarea>
        </div>
      </fieldset>

      <div><button type="button">Amend details</button></div>
      <div><button type="submit">Submit</button></div>
    </form>
</body>

</html>

body {
  font-family: 'Josefin Sans', sans-serif;
  margin: 20px auto;
  max-width: 460px;
}

fieldset {
  padding: 10px 30px 0;
  margin-bottom: 20px;
}

legend {
  color: white;
  background: black;
  padding: 5px 10px;
}

fieldset > div {
  margin-bottom: 20px;
  display: flex;
  justify-content: space-between;
}

button, label, input[type="text"], textarea {
  display: block;
  font-family: inherit;
  font-size: 100%;
  padding: 0;
  margin: 0;
  box-sizing: border-box;
  padding: 5px;
  height: 30px;
}

input[type="text"], textarea {
  width: 50%;
}

textarea {
  height: 110px;
  resize: none;
}

label {
  width: 40%;
}

input:hover, input:focus, textarea:hover, textarea:focus {
  background-color: #eee;
}

button {
  width: 60%;
  margin: 20px auto;
}

input:read-only, textarea:read-only {
  border: 0;
  box-shadow: none;
  background-color: white;
}

textarea:read-write {
  box-shadow: inset 1px 1px 3px #ccc;
  border-radius: 5px;
}

External CSS

This Pen doesn't use any external CSS resources.

External JavaScript

This Pen doesn't use any external JavaScript resources.