<div>
  <fieldset>
    <legend>
      Next of Kin Contact Information
    </legend>
    <div>
      <label for="address">Address</label>
      <input type="text" id="address">
    </div>
    <div>
      <label for="city">City</label>
      <input type="text" id="city">
    </div>
    <div>
      <label for="country">Country</label>
      <input type="text" id="country">
    </div>
    <div>
      <label for=""></label>
    </div>
  </fieldset>
  
  <fieldset>
    <legend>Subscribe for newsletter</legend>
    <div>
    <input type="radio" name="subscribe" id="no" value="yes" checked>
    <label for="txt">Yes</label>
  </div>
  <div>
    <input type="radio" name="subscribe" id="no" value="no">
    <label for="csv">No</label>
  </div>
  </fieldset>
</div>