covid-certificati.dev.oneam.it Open in urlscan Pro
51.195.64.33  Public Scan

Form analysis
1 forms found in the DOM

Name: certificate — POST

<form name="certificate" method="post">
  <div id="certificate">
    <div class="form-group"><label for="certificate_surname" class="required">Cognome</label><input type="text" id="certificate_surname" name="certificate[surname]" required="required" class="form-control"></div>
    <div class="form-group"><label for="certificate_name" class="required">Nome</label><input type="text" id="certificate_name" name="certificate[name]" required="required" class="form-control"></div>
    <div class="form-group"><label class="required" for="certificate_sex">Sex</label><select id="certificate_sex" name="certificate[sex]" class="kt-selectpicker form-control">
        <option value="male">male</option>
        <option value="female">female</option>
      </select></div>
    <div class="form-group"><label for="certificate_born" class="required">Born</label><input type="date" id="certificate_born" name="certificate[born]" required="required" class="form-control"></div>
    <div class="form-group"><label for="certificate_date" class="required">Date</label><input type="date" id="certificate_date" name="certificate[date]" required="required" class="form-control"></div><input type="hidden" id="certificate__token"
      name="certificate[_token]" value="7U647nqrMnqH-auD0GWWGIgi1f7_g8s99-L6rcq7VzI">
  </div>
  <button class="btn btn-primary">Genera PDF</button>
</form>

Text Content

Cognome
Nome
Sexmalefemale
Born
Date
Genera PDF