Just select the hindrance you want to add from the drop-down and press the Add button. Your hindrance will show up on the Installed Hindrances area and your perk points will be adjusted as per the rules of your selected primary book.
You can add a custom Hindrances here too! Please see the help for Custom Items.
This area won't show up until you've selected a hindrance.
To apply your perk, just select the perk from the drop-down and and click the nearby Add button.
Your Perk Points and Character will be adjusted to the selection.
Your selected and installed hindrances will show up here. Some hindrances will have options to type in some text to specify to what the hindrance pertains to (such as, what your character has a Phobia of, etc), and it also may have a checkbox to whether it's a Major or a Minor hindrance (this is mainly in SWADE since we now have an option to reduce or remove a hindrance entirely now).
Your custom hindrances will show up here.
Any racial abilities that are tagged as 'hindrances' will show up here.
Any hindrances added from an effect, cyberware, or anything else will show up here.