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hoithaovuotcandedang.trikhangpharma.com Open in urlscan Pro
54.179.173.60  Public Scan

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URL: https://hoithaovuotcandedang.trikhangpharma.com/
Submission: On June 12 via api from US — Scanned from SG

Form analysis 1 forms found in the DOM

POST 

<form autocomplete="off" method="post" class="ladi-form">
  <div id="BUTTON3" class="ladi-element">
    <div class="ladi-button ladi-transition">
      <div class="ladi-button-background"></div>
      <div id="BUTTON_TEXT3" class="ladi-element ladi-button-headline">
        <p class="ladi-headline ladi-transition">Gửi thông tin</p>
      </div>
    </div>
  </div>
  <div id="FORM_ITEM2" class="ladi-element">
    <div class="ladi-form-item-container">
      <div class="ladi-form-item-background"></div>
      <div class="ladi-form-item"><input autocomplete="off" tabindex="1" name="name" required="" class="ladi-form-control" type="text" placeholder="Họ và Tên" value=""></div>
    </div>
  </div>
  <div id="FORM_ITEM4" class="ladi-element">
    <div class="ladi-form-item-container">
      <div class="ladi-form-item-background"></div>
      <div class="ladi-form-item"><input autocomplete="off" tabindex="3" name="phone" required="" class="ladi-form-control" type="tel" placeholder="Số điện thoại" pattern="(\+84|0)(9|8|7|5|3)[0-9]{8}" value=""></div>
    </div>
  </div>
  <div id="FORM_ITEM5" class="ladi-element">
    <div class="ladi-form-item-container">
      <div class="ladi-form-item-background"></div>
      <div class="ladi-form-item"><textarea autocomplete="off" tabindex="4" name="message" required="" class="ladi-form-control" placeholder="Câu hỏi dành cho chuyên gia"></textarea></div>
    </div>
  </div>
  <div id="FORM_ITEM6" class="ladi-element">
    <div class="ladi-form-item-container">
      <div class="ladi-form-item-background"></div>
      <div class="ladi-form-item"><input autocomplete="off" tabindex="4" name="address" required="" class="ladi-form-control" type="text" placeholder="Khu vực" value=""></div>
    </div>
  </div>
  <div id="FORM_ITEM9" class="ladi-element">
    <div class="ladi-form-item-container">
      <div class="ladi-form-item-background"></div>
      <div class="ladi-form-item ladi-form-checkbox ladi-form-checkbox-vertical" ladi-checkbox-required="true">
        <div class="ladi-form-checkbox-box-item">
          <div class="ladi-form-checkbox-item"><input tabindex="6" name="Tình trạng" type="checkbox" value="Bạn đang nuôi con nhỏ"><span data-checked="false">Bạn đang nuôi con nhỏ</span></div>
          <div class="ladi-form-checkbox-item"><input tabindex="6" name="Tình trạng" type="checkbox" value="Bạn đang mang thai"><span data-checked="false">Bạn đang mang thai</span></div>
        </div>
      </div>
    </div>
  </div><button type="submit" class="ladi-hidden"></button>
</form>

Text Content

ĐĂNG KÝ NGAY

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