imunocare.azizsembada.com Open in urlscan Pro
2606:4700:3031::6815:309e  Public Scan

Form analysis
1 forms found in the DOM

POST /auth-process

<form id="formAuthentication" class="mb-3 fv-plugins-bootstrap5 fv-plugins-framework" action="/auth-process" method="POST" novalidate="novalidate">
  <div class="mb-3">
    <label for="email" class="form-label">NIK</label>
    <input type="hidden" class="txt_csrfname" name="csrf_token_name" value="22819effc58545fbb6c27df75e0a3f18">
    <input type="text" class="form-control" id="nik" name="nik" placeholder="Masukan NIK" autofocus="">
  </div>
  <div class="mb-3 form-password-toggle fv-plugins-icon-container">
    <div class="d-flex justify-content-between">
      <label class="form-label" for="password">Password</label>
      <a href="auth-forgot-password-cover.html">
                                    <small>Forgot Password?</small>
                                </a>
    </div>
    <div class="input-group input-group-merge has-validation">
      <input type="password" id="password" class="form-control" name="password" placeholder="············" aria-describedby="password">
      <span class="input-group-text cursor-pointer"><i class="ti ti-eye-off"></i></span>
    </div>
    <div class="fv-plugins-message-container fv-plugins-message-container--enabled invalid-feedback"></div>
  </div>
  <div class="mb-3">
    <div class="form-check">
      <input class="form-check-input" type="checkbox" id="remember-me">
      <label class="form-check-label" for="remember-me"> Remember Me </label>
    </div>
  </div>
  <button class="btn btn-primary d-grid w-100 waves-effect waves-light">Sign in</button>
  <input type="hidden">
</form>

Text Content

Silahkan Login untuk mendapatkan layanan kami

NIK
Password Forgot Password?


Remember Me
Sign in

New on our platform? Create an account

or


TEMPLATE CUSTOMIZER

Customize and preview in real time



THEMING

Style (Mode)

Light

Dark

System
Themes

Default

Bordered

Semi Dark

--------------------------------------------------------------------------------

LAYOUT

Menu (Navigation)

Expanded

Collapsed
Navbar Type

Sticky

Static

Hidden
Content

Compact

Wide
Direction

Left to Right (En)

Right to Left (Ar)