mua.co.tz Open in urlscan Pro
196.27.73.148 Public Scan

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Submitted URL:
https://phoenix-assurance.co.tz/
Effective URL:
https://mua.co.tz/
Submission: On September 24 via automatic, source certstream-suspicious (September 24th 2024, 4:48:29 am UTC) — Scanned from NL

Form analysis
6 forms found in the DOM

POST /

<form
  class="webform-submission-form webform-submission-add-form webform-submission-individual-motor-form webform-submission-individual-motor-add-form webform-submission-individual-motor-node-15-form webform-submission-individual-motor-node-15-add-form js-webform-details-toggle webform-details-toggle"
  data-drupal-selector="webform-submission-individual-motor-node-15-add-form" action="/" method="post" id="webform-submission-individual-motor-node-15-add-form" accept-charset="UTF-8" data-once="form-updated"
  data-drupal-form-fields="edit-first-name--4,edit-surname--4,edit-phone--4,edit-email--11,edit-message--10,edit-actions-submit--11" novalidate="novalidate">
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'webform_submission_form' -->
  <!-- FILE NAME SUGGESTIONS:
   * webform-submission-form--individual-motor.html.twig
   x webform-submission-form.html.twig
-->
  <!-- BEGIN OUTPUT from 'modules/contrib/webform/templates/webform-submission-form.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'form_element' -->
  <!-- FILE NAME SUGGESTIONS:
   * form-element--webform-textfield.html.twig
   x form-element.html.twig
-->
  <!-- BEGIN OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col-half js-form-item form-item js-form-type-textfield form-item-first-name js-form-item-first-name form-no-label">
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'form_element_label' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <label for="edit-first-name--4" class="visually-hidden js-form-required form-required">First name</label>
    <!-- END OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'input__textfield' -->
    <!-- FILE NAME SUGGESTIONS:
   * input--textfield.html.twig
   x input.html.twig
-->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
    <input data-webform-required-error="Please enter your first name" data-drupal-selector="edit-first-name" data-msg-maxlength="First name field has a maximum length of 255." data-msg-required="Please enter your first name" type="text"
      id="edit-first-name--4" name="first_name" value="" size="60" maxlength="255" placeholder="First Name" class="form-text required" required="required" aria-required="true">
    <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  </div>
  <!-- END OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'form_element' -->
  <!-- FILE NAME SUGGESTIONS:
   * form-element--webform-textfield.html.twig
   x form-element.html.twig
-->
  <!-- BEGIN OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col-half js-form-item form-item js-form-type-textfield form-item-surname js-form-item-surname form-no-label">
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'form_element_label' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <label for="edit-surname--4" class="visually-hidden js-form-required form-required">Surname</label>
    <!-- END OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'input__textfield' -->
    <!-- FILE NAME SUGGESTIONS:
   * input--textfield.html.twig
   x input.html.twig
-->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
    <input data-webform-required-error="Please enter your surname" data-drupal-selector="edit-surname" data-msg-maxlength="Surname field has a maximum length of 255." data-msg-required="Please enter your surname" type="text" id="edit-surname--4"
      name="surname" value="" size="60" maxlength="255" placeholder="Surname" class="form-text required" required="required" aria-required="true">
    <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  </div>
  <!-- END OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'form_element' -->
  <!-- FILE NAME SUGGESTIONS:
   * form-element--webform-tel.html.twig
   x form-element.html.twig
-->
  <!-- BEGIN OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col-half js-form-item form-item js-form-type-tel form-item-phone js-form-item-phone form-no-label">
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'form_element_label' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <label for="edit-phone--4" class="visually-hidden">Phone</label>
    <!-- END OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'input__tel' -->
    <!-- FILE NAME SUGGESTIONS:
   * input--tel.html.twig
   x input.html.twig
-->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
    <input pattern="^[0-9]*$" data-drupal-selector="edit-phone" data-msg-maxlength="Phone field has a maximum length of 128." data-msg-pattern="Phone does not meet the requirements." type="tel" id="edit-phone--4" name="phone" value="" size="30"
      maxlength="128" placeholder="Phone" class="form-tel">
    <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  </div>
  <!-- END OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'form_element' -->
  <!-- FILE NAME SUGGESTIONS:
   * form-element--webform-email.html.twig
   x form-element.html.twig
-->
  <!-- BEGIN OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col-half js-form-item form-item js-form-type-email form-item-email js-form-item-email form-no-label">
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'form_element_label' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <label for="edit-email--11" class="visually-hidden js-form-required form-required">Email</label>
    <!-- END OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'input__email' -->
    <!-- FILE NAME SUGGESTIONS:
   * input--email.html.twig
   x input.html.twig
-->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
    <input data-webform-required-error="Please enter your email address" data-drupal-selector="edit-email" data-msg-maxlength="Email field has a maximum length of 254." data-msg-email="Email does not contain a valid email."
      data-msg-required="Please enter your email address" type="email" id="edit-email--11" name="email" value="" size="60" maxlength="254" placeholder="Email" class="form-email required" required="required" aria-required="true">
    <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  </div>
  <!-- END OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'form_element' -->
  <!-- FILE NAME SUGGESTIONS:
   * form-element--webform-textarea.html.twig
   x form-element.html.twig
-->
  <!-- BEGIN OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col_12 js-form-item form-item js-form-type-textarea form-item-message js-form-item-message form-no-label">
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'form_element_label' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <label for="edit-message--10" class="visually-hidden js-form-required form-required">Message</label>
    <!-- END OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'textarea' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/textarea.html.twig' -->
    <div>
      <textarea data-webform-required-error="Please enter your message" data-drupal-selector="edit-message" data-msg-required="Please enter your message" id="edit-message--10" name="message" rows="5" cols="60" placeholder="Message"
        class="form-textarea required" required="required" aria-required="true"></textarea>
    </div>
    <!-- END OUTPUT from 'core/modules/system/templates/textarea.html.twig' -->
  </div>
  <!-- END OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col_12 input_submit">
    <div class="btn_line btn_orange">
      <div class="btn_hover">
        <div class="input_btn">
          <!-- THEME DEBUG -->
          <!-- THEME HOOK: 'container' -->
          <!-- BEGIN OUTPUT from 'themes/custom/front/templates/container.html.twig' -->
          <div data-drupal-selector="edit-actions" class="form-actions webform-actions js-form-wrapper form-wrapper" id="edit-actions--21">
            <!-- THEME DEBUG -->
            <!-- THEME HOOK: 'webform_actions' -->
            <!-- BEGIN OUTPUT from 'modules/contrib/webform/templates/webform-actions.html.twig' -->
            <!-- THEME DEBUG -->
            <!-- THEME HOOK: 'input__submit' -->
            <!-- FILE NAME SUGGESTIONS:
   * input--submit.html.twig
   x input.html.twig
-->
            <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
            <input class="webform-button--submit button button--primary js-form-submit form-submit" data-drupal-selector="edit-actions-submit-11" data-disable-refocus="true" type="submit" id="edit-actions-submit--11" name="op" value="Submit"
              data-once="drupal-ajax">
            <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
            <!-- END OUTPUT from 'modules/contrib/webform/templates/webform-actions.html.twig' -->
          </div>
          <!-- END OUTPUT from 'themes/custom/front/templates/container.html.twig' -->
        </div>
      </div>
    </div>
  </div>
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'input__hidden' -->
  <!-- FILE NAME SUGGESTIONS:
   * input--hidden.html.twig
   x input.html.twig
-->
  <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  <input autocomplete="off" data-drupal-selector="form-xsfequwgncizacw4uxa3sf0ffwunr8-gp-xddryaadq" type="hidden" name="form_build_id" value="form-xSfEquwGnCIZACW4UxA3Sf0FfWunr8_gp_XDDrYaADQ">
  <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'input__hidden' -->
  <!-- FILE NAME SUGGESTIONS:
   * input--hidden.html.twig
   x input.html.twig
-->
  <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  <input data-drupal-selector="edit-webform-submission-individual-motor-node-15-add-form" type="hidden" name="form_id" value="webform_submission_individual_motor_node_15_add_form">
  <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  <!-- END OUTPUT from 'modules/contrib/webform/templates/webform-submission-form.html.twig' -->
</form>

POST /

<form
  class="webform-submission-form webform-submission-add-form webform-submission-individual-domestic-package-form webform-submission-individual-domestic-package-add-form webform-submission-individual-domestic-package-node-15-form webform-submission-individual-domestic-package-node-15-add-form js-webform-details-toggle webform-details-toggle"
  data-drupal-selector="webform-submission-individual-domestic-package-node-15-add-form" action="/" method="post" id="webform-submission-individual-domestic-package-node-15-add-form" accept-charset="UTF-8" data-once="form-updated"
  data-drupal-form-fields="edit-first-name--3,edit-surname--3,edit-phone--3,edit-email--10,edit-message--9,edit-actions-submit--10" novalidate="novalidate">
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'webform_submission_form' -->
  <!-- FILE NAME SUGGESTIONS:
   * webform-submission-form--individual-domestic-package.html.twig
   x webform-submission-form.html.twig
-->
  <!-- BEGIN OUTPUT from 'modules/contrib/webform/templates/webform-submission-form.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'form_element' -->
  <!-- FILE NAME SUGGESTIONS:
   * form-element--webform-textfield.html.twig
   x form-element.html.twig
-->
  <!-- BEGIN OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col-half js-form-item form-item js-form-type-textfield form-item-first-name js-form-item-first-name form-no-label">
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'form_element_label' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <label for="edit-first-name--3" class="visually-hidden js-form-required form-required">First name</label>
    <!-- END OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'input__textfield' -->
    <!-- FILE NAME SUGGESTIONS:
   * input--textfield.html.twig
   x input.html.twig
-->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
    <input data-webform-required-error="Please enter your first name" data-drupal-selector="edit-first-name" data-msg-maxlength="First name field has a maximum length of 255." data-msg-required="Please enter your first name" type="text"
      id="edit-first-name--3" name="first_name" value="" size="60" maxlength="255" placeholder="First Name" class="form-text required" required="required" aria-required="true">
    <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  </div>
  <!-- END OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'form_element' -->
  <!-- FILE NAME SUGGESTIONS:
   * form-element--webform-textfield.html.twig
   x form-element.html.twig
-->
  <!-- BEGIN OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col-half js-form-item form-item js-form-type-textfield form-item-surname js-form-item-surname form-no-label">
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'form_element_label' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <label for="edit-surname--3" class="visually-hidden js-form-required form-required">Surname</label>
    <!-- END OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'input__textfield' -->
    <!-- FILE NAME SUGGESTIONS:
   * input--textfield.html.twig
   x input.html.twig
-->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
    <input data-webform-required-error="Please enter your surname" data-drupal-selector="edit-surname" data-msg-maxlength="Surname field has a maximum length of 255." data-msg-required="Please enter your surname" type="text" id="edit-surname--3"
      name="surname" value="" size="60" maxlength="255" placeholder="Surname" class="form-text required" required="required" aria-required="true">
    <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  </div>
  <!-- END OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'form_element' -->
  <!-- FILE NAME SUGGESTIONS:
   * form-element--webform-tel.html.twig
   x form-element.html.twig
-->
  <!-- BEGIN OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col-half js-form-item form-item js-form-type-tel form-item-phone js-form-item-phone form-no-label">
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'form_element_label' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <label for="edit-phone--3" class="visually-hidden">Phone</label>
    <!-- END OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'input__tel' -->
    <!-- FILE NAME SUGGESTIONS:
   * input--tel.html.twig
   x input.html.twig
-->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
    <input pattern="^[0-9]*$" data-drupal-selector="edit-phone" data-msg-maxlength="Phone field has a maximum length of 128." data-msg-pattern="Phone does not meet the requirements." type="tel" id="edit-phone--3" name="phone" value="" size="30"
      maxlength="128" placeholder="Phone" class="form-tel">
    <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  </div>
  <!-- END OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'form_element' -->
  <!-- FILE NAME SUGGESTIONS:
   * form-element--webform-email.html.twig
   x form-element.html.twig
-->
  <!-- BEGIN OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col-half js-form-item form-item js-form-type-email form-item-email js-form-item-email form-no-label">
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'form_element_label' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <label for="edit-email--10" class="visually-hidden js-form-required form-required">Email</label>
    <!-- END OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'input__email' -->
    <!-- FILE NAME SUGGESTIONS:
   * input--email.html.twig
   x input.html.twig
-->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
    <input data-webform-required-error="Please enter your email address" data-drupal-selector="edit-email" data-msg-maxlength="Email field has a maximum length of 254." data-msg-email="Email does not contain a valid email."
      data-msg-required="Please enter your email address" type="email" id="edit-email--10" name="email" value="" size="60" maxlength="254" placeholder="Email" class="form-email required" required="required" aria-required="true">
    <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  </div>
  <!-- END OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'form_element' -->
  <!-- FILE NAME SUGGESTIONS:
   * form-element--webform-textarea.html.twig
   x form-element.html.twig
-->
  <!-- BEGIN OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col_12 js-form-item form-item js-form-type-textarea form-item-message js-form-item-message form-no-label">
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'form_element_label' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <label for="edit-message--9" class="visually-hidden js-form-required form-required">Message</label>
    <!-- END OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'textarea' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/textarea.html.twig' -->
    <div>
      <textarea data-webform-required-error="Please enter your message" data-drupal-selector="edit-message" data-msg-required="Please enter your message" id="edit-message--9" name="message" rows="5" cols="60" placeholder="Message"
        class="form-textarea required" required="required" aria-required="true"></textarea>
    </div>
    <!-- END OUTPUT from 'core/modules/system/templates/textarea.html.twig' -->
  </div>
  <!-- END OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col_12 input_submit">
    <div class="btn_line btn_orange">
      <div class="btn_hover">
        <div class="input_btn">
          <!-- THEME DEBUG -->
          <!-- THEME HOOK: 'container' -->
          <!-- BEGIN OUTPUT from 'themes/custom/front/templates/container.html.twig' -->
          <div data-drupal-selector="edit-actions" class="form-actions webform-actions js-form-wrapper form-wrapper" id="edit-actions--19">
            <!-- THEME DEBUG -->
            <!-- THEME HOOK: 'webform_actions' -->
            <!-- BEGIN OUTPUT from 'modules/contrib/webform/templates/webform-actions.html.twig' -->
            <!-- THEME DEBUG -->
            <!-- THEME HOOK: 'input__submit' -->
            <!-- FILE NAME SUGGESTIONS:
   * input--submit.html.twig
   x input.html.twig
-->
            <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
            <input class="webform-button--submit button button--primary js-form-submit form-submit" data-drupal-selector="edit-actions-submit-10" data-disable-refocus="true" type="submit" id="edit-actions-submit--10" name="op" value="Submit"
              data-once="drupal-ajax">
            <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
            <!-- END OUTPUT from 'modules/contrib/webform/templates/webform-actions.html.twig' -->
          </div>
          <!-- END OUTPUT from 'themes/custom/front/templates/container.html.twig' -->
        </div>
      </div>
    </div>
  </div>
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'input__hidden' -->
  <!-- FILE NAME SUGGESTIONS:
   * input--hidden.html.twig
   x input.html.twig
-->
  <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  <input autocomplete="off" data-drupal-selector="form-gl6wns-tdytas1qcobpxjyi9ldyluu3el6sl-5iwlfo" type="hidden" name="form_build_id" value="form-GL6wnS-tDyTaS1QCobPxjYI9LDYLUu3eL6SL-5IwLfo">
  <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'input__hidden' -->
  <!-- FILE NAME SUGGESTIONS:
   * input--hidden.html.twig
   x input.html.twig
-->
  <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  <input data-drupal-selector="edit-webform-submission-individual-domestic-package-node-15-add-form" type="hidden" name="form_id" value="webform_submission_individual_domestic_package_node_15_add_form">
  <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  <!-- END OUTPUT from 'modules/contrib/webform/templates/webform-submission-form.html.twig' -->
</form>

POST /

<form
  class="webform-submission-form webform-submission-add-form webform-submission-individual-health-form webform-submission-individual-health-add-form webform-submission-individual-health-node-15-form webform-submission-individual-health-node-15-add-form js-webform-details-toggle webform-details-toggle"
  data-drupal-selector="webform-submission-individual-health-node-15-add-form" action="/" method="post" id="webform-submission-individual-health-node-15-add-form" accept-charset="UTF-8" data-once="form-updated"
  data-drupal-form-fields="edit-first-name,edit-surname,edit-phone,edit-email--8,edit-message--7,edit-actions-submit--8" novalidate="novalidate">
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'webform_submission_form' -->
  <!-- FILE NAME SUGGESTIONS:
   * webform-submission-form--individual-health.html.twig
   x webform-submission-form.html.twig
-->
  <!-- BEGIN OUTPUT from 'modules/contrib/webform/templates/webform-submission-form.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'form_element' -->
  <!-- FILE NAME SUGGESTIONS:
   * form-element--webform-textfield.html.twig
   x form-element.html.twig
-->
  <!-- BEGIN OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col-half js-form-item form-item js-form-type-textfield form-item-first-name js-form-item-first-name form-no-label">
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'form_element_label' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <label for="edit-first-name" class="visually-hidden js-form-required form-required">First name</label>
    <!-- END OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'input__textfield' -->
    <!-- FILE NAME SUGGESTIONS:
   * input--textfield.html.twig
   x input.html.twig
-->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
    <input data-webform-required-error="Please enter your first name" data-drupal-selector="edit-first-name" data-msg-maxlength="First name field has a maximum length of 255." data-msg-required="Please enter your first name" type="text"
      id="edit-first-name" name="first_name" value="" size="60" maxlength="255" placeholder="First Name" class="form-text required" required="required" aria-required="true">
    <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  </div>
  <!-- END OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'form_element' -->
  <!-- FILE NAME SUGGESTIONS:
   * form-element--webform-textfield.html.twig
   x form-element.html.twig
-->
  <!-- BEGIN OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col-half js-form-item form-item js-form-type-textfield form-item-surname js-form-item-surname form-no-label">
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'form_element_label' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <label for="edit-surname" class="visually-hidden js-form-required form-required">Surname</label>
    <!-- END OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'input__textfield' -->
    <!-- FILE NAME SUGGESTIONS:
   * input--textfield.html.twig
   x input.html.twig
-->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
    <input data-webform-required-error="Please enter your surname" data-drupal-selector="edit-surname" data-msg-maxlength="Surname field has a maximum length of 255." data-msg-required="Please enter your surname" type="text" id="edit-surname"
      name="surname" value="" size="60" maxlength="255" placeholder="Surname" class="form-text required" required="required" aria-required="true">
    <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  </div>
  <!-- END OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'form_element' -->
  <!-- FILE NAME SUGGESTIONS:
   * form-element--webform-tel.html.twig
   x form-element.html.twig
-->
  <!-- BEGIN OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col-half js-form-item form-item js-form-type-tel form-item-phone js-form-item-phone form-no-label">
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'form_element_label' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <label for="edit-phone" class="visually-hidden">Phone</label>
    <!-- END OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'input__tel' -->
    <!-- FILE NAME SUGGESTIONS:
   * input--tel.html.twig
   x input.html.twig
-->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
    <input pattern="^[0-9]*$" data-drupal-selector="edit-phone" data-msg-maxlength="Phone field has a maximum length of 128." data-msg-pattern="Phone does not meet the requirements." type="tel" id="edit-phone" name="phone" value="" size="30"
      maxlength="128" placeholder="Phone" class="form-tel">
    <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  </div>
  <!-- END OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'form_element' -->
  <!-- FILE NAME SUGGESTIONS:
   * form-element--webform-email.html.twig
   x form-element.html.twig
-->
  <!-- BEGIN OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col-half js-form-item form-item js-form-type-email form-item-email js-form-item-email form-no-label">
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'form_element_label' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <label for="edit-email--8" class="visually-hidden js-form-required form-required">Email</label>
    <!-- END OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'input__email' -->
    <!-- FILE NAME SUGGESTIONS:
   * input--email.html.twig
   x input.html.twig
-->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
    <input data-webform-required-error="Please enter your email address" data-drupal-selector="edit-email" data-msg-maxlength="Email field has a maximum length of 254." data-msg-email="Email does not contain a valid email."
      data-msg-required="Please enter your email address" type="email" id="edit-email--8" name="email" value="" size="60" maxlength="254" placeholder="Email" class="form-email required" required="required" aria-required="true">
    <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  </div>
  <!-- END OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'form_element' -->
  <!-- FILE NAME SUGGESTIONS:
   * form-element--webform-textarea.html.twig
   x form-element.html.twig
-->
  <!-- BEGIN OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col_12 js-form-item form-item js-form-type-textarea form-item-message js-form-item-message form-no-label">
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'form_element_label' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <label for="edit-message--7" class="visually-hidden js-form-required form-required">Message</label>
    <!-- END OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'textarea' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/textarea.html.twig' -->
    <div>
      <textarea data-webform-required-error="Please enter your message" data-drupal-selector="edit-message" data-msg-required="Please enter your message" id="edit-message--7" name="message" rows="5" cols="60" placeholder="Message"
        class="form-textarea required" required="required" aria-required="true"></textarea>
    </div>
    <!-- END OUTPUT from 'core/modules/system/templates/textarea.html.twig' -->
  </div>
  <!-- END OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col_12 input_submit">
    <div class="btn_line btn_orange">
      <div class="btn_hover">
        <div class="input_btn">
          <!-- THEME DEBUG -->
          <!-- THEME HOOK: 'container' -->
          <!-- BEGIN OUTPUT from 'themes/custom/front/templates/container.html.twig' -->
          <div data-drupal-selector="edit-actions" class="form-actions webform-actions js-form-wrapper form-wrapper" id="edit-actions--15">
            <!-- THEME DEBUG -->
            <!-- THEME HOOK: 'webform_actions' -->
            <!-- BEGIN OUTPUT from 'modules/contrib/webform/templates/webform-actions.html.twig' -->
            <!-- THEME DEBUG -->
            <!-- THEME HOOK: 'input__submit' -->
            <!-- FILE NAME SUGGESTIONS:
   * input--submit.html.twig
   x input.html.twig
-->
            <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
            <input class="webform-button--submit button button--primary js-form-submit form-submit" data-drupal-selector="edit-actions-submit-8" data-disable-refocus="true" type="submit" id="edit-actions-submit--8" name="op" value="Submit"
              data-once="drupal-ajax">
            <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
            <!-- END OUTPUT from 'modules/contrib/webform/templates/webform-actions.html.twig' -->
          </div>
          <!-- END OUTPUT from 'themes/custom/front/templates/container.html.twig' -->
        </div>
      </div>
    </div>
  </div>
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'input__hidden' -->
  <!-- FILE NAME SUGGESTIONS:
   * input--hidden.html.twig
   x input.html.twig
-->
  <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  <input data-drupal-selector="edit-recapcha-element" data-recaptcha-element="" data-recaptcha-element-action="default" data-recaptcha-element-site-key="6Lf-BgYeAAAAACikzDPv68DWJEfJFkAFrcaOC_PU" type="hidden" name="recapcha_element" value="">
  <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'input__hidden' -->
  <!-- FILE NAME SUGGESTIONS:
   * input--hidden.html.twig
   x input.html.twig
-->
  <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  <input autocomplete="off" data-drupal-selector="form-w7xuj5kdxdoonbo0mcycataxl04frgtcqsxgiwu6fm8" type="hidden" name="form_build_id" value="form-W7Xuj5KdXdOonbO0mcYcataxL04frgTCQSxGIwu6FM8">
  <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'input__hidden' -->
  <!-- FILE NAME SUGGESTIONS:
   * input--hidden.html.twig
   x input.html.twig
-->
  <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  <input data-drupal-selector="edit-webform-submission-individual-health-node-15-add-form" type="hidden" name="form_id" value="webform_submission_individual_health_node_15_add_form">
  <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  <!-- END OUTPUT from 'modules/contrib/webform/templates/webform-submission-form.html.twig' -->
</form>

POST /

<form
  class="webform-submission-form webform-submission-add-form webform-submission-individual-life-form webform-submission-individual-life-add-form webform-submission-individual-life-node-15-form webform-submission-individual-life-node-15-add-form js-webform-details-toggle webform-details-toggle"
  data-drupal-selector="webform-submission-individual-life-node-15-add-form" action="/" method="post" id="webform-submission-individual-life-node-15-add-form" accept-charset="UTF-8" data-once="form-updated"
  data-drupal-form-fields="edit-first-name--2,edit-surname--2,edit-phone--2,edit-email--9,edit-message--8,edit-actions-submit--9" novalidate="novalidate">
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'webform_submission_form' -->
  <!-- FILE NAME SUGGESTIONS:
   * webform-submission-form--individual-life.html.twig
   x webform-submission-form.html.twig
-->
  <!-- BEGIN OUTPUT from 'modules/contrib/webform/templates/webform-submission-form.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'form_element' -->
  <!-- FILE NAME SUGGESTIONS:
   * form-element--webform-textfield.html.twig
   x form-element.html.twig
-->
  <!-- BEGIN OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col-half js-form-item form-item js-form-type-textfield form-item-first-name js-form-item-first-name form-no-label">
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'form_element_label' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <label for="edit-first-name--2" class="visually-hidden js-form-required form-required">First name</label>
    <!-- END OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'input__textfield' -->
    <!-- FILE NAME SUGGESTIONS:
   * input--textfield.html.twig
   x input.html.twig
-->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
    <input data-webform-required-error="Please enter your first name" data-drupal-selector="edit-first-name" data-msg-maxlength="First name field has a maximum length of 255." data-msg-required="Please enter your first name" type="text"
      id="edit-first-name--2" name="first_name" value="" size="60" maxlength="255" placeholder="First Name" class="form-text required" required="required" aria-required="true">
    <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  </div>
  <!-- END OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'form_element' -->
  <!-- FILE NAME SUGGESTIONS:
   * form-element--webform-textfield.html.twig
   x form-element.html.twig
-->
  <!-- BEGIN OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col-half js-form-item form-item js-form-type-textfield form-item-surname js-form-item-surname form-no-label">
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'form_element_label' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <label for="edit-surname--2" class="visually-hidden js-form-required form-required">Surname</label>
    <!-- END OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'input__textfield' -->
    <!-- FILE NAME SUGGESTIONS:
   * input--textfield.html.twig
   x input.html.twig
-->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
    <input data-webform-required-error="Please enter your surname" data-drupal-selector="edit-surname" data-msg-maxlength="Surname field has a maximum length of 255." data-msg-required="Please enter your surname" type="text" id="edit-surname--2"
      name="surname" value="" size="60" maxlength="255" placeholder="Surname" class="form-text required" required="required" aria-required="true">
    <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  </div>
  <!-- END OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'form_element' -->
  <!-- FILE NAME SUGGESTIONS:
   * form-element--webform-tel.html.twig
   x form-element.html.twig
-->
  <!-- BEGIN OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col-half js-form-item form-item js-form-type-tel form-item-phone js-form-item-phone form-no-label">
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'form_element_label' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <label for="edit-phone--2" class="visually-hidden">Phone</label>
    <!-- END OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'input__tel' -->
    <!-- FILE NAME SUGGESTIONS:
   * input--tel.html.twig
   x input.html.twig
-->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
    <input pattern="^[0-9]*$" data-drupal-selector="edit-phone" data-msg-maxlength="Phone field has a maximum length of 128." data-msg-pattern="Phone does not meet the requirements." type="tel" id="edit-phone--2" name="phone" value="" size="30"
      maxlength="128" placeholder="Phone" class="form-tel">
    <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  </div>
  <!-- END OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'form_element' -->
  <!-- FILE NAME SUGGESTIONS:
   * form-element--webform-email.html.twig
   x form-element.html.twig
-->
  <!-- BEGIN OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col-half js-form-item form-item js-form-type-email form-item-email js-form-item-email form-no-label">
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'form_element_label' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <label for="edit-email--9" class="visually-hidden js-form-required form-required">Email</label>
    <!-- END OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'input__email' -->
    <!-- FILE NAME SUGGESTIONS:
   * input--email.html.twig
   x input.html.twig
-->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
    <input data-webform-required-error="Please enter your email address" data-drupal-selector="edit-email" data-msg-maxlength="Email field has a maximum length of 254." data-msg-email="Email does not contain a valid email."
      data-msg-required="Please enter your email address" type="email" id="edit-email--9" name="email" value="" size="60" maxlength="254" placeholder="Email" class="form-email required" required="required" aria-required="true">
    <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  </div>
  <!-- END OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'form_element' -->
  <!-- FILE NAME SUGGESTIONS:
   * form-element--webform-textarea.html.twig
   x form-element.html.twig
-->
  <!-- BEGIN OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col_12 js-form-item form-item js-form-type-textarea form-item-message js-form-item-message form-no-label">
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'form_element_label' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <label for="edit-message--8" class="visually-hidden js-form-required form-required">Message</label>
    <!-- END OUTPUT from 'core/modules/system/templates/form-element-label.html.twig' -->
    <!-- THEME DEBUG -->
    <!-- THEME HOOK: 'textarea' -->
    <!-- BEGIN OUTPUT from 'core/modules/system/templates/textarea.html.twig' -->
    <div>
      <textarea data-webform-required-error="Please enter your message" data-drupal-selector="edit-message" data-msg-required="Please enter your message" id="edit-message--8" name="message" rows="5" cols="60" placeholder="Message"
        class="form-textarea required" required="required" aria-required="true"></textarea>
    </div>
    <!-- END OUTPUT from 'core/modules/system/templates/textarea.html.twig' -->
  </div>
  <!-- END OUTPUT from 'themes/custom/front/templates/form-element.html.twig' -->
  <div class="col_12 input_submit">
    <div class="btn_line btn_orange">
      <div class="btn_hover">
        <div class="input_btn">
          <!-- THEME DEBUG -->
          <!-- THEME HOOK: 'container' -->
          <!-- BEGIN OUTPUT from 'themes/custom/front/templates/container.html.twig' -->
          <div data-drupal-selector="edit-actions" class="form-actions webform-actions js-form-wrapper form-wrapper" id="edit-actions--17">
            <!-- THEME DEBUG -->
            <!-- THEME HOOK: 'webform_actions' -->
            <!-- BEGIN OUTPUT from 'modules/contrib/webform/templates/webform-actions.html.twig' -->
            <!-- THEME DEBUG -->
            <!-- THEME HOOK: 'input__submit' -->
            <!-- FILE NAME SUGGESTIONS:
   * input--submit.html.twig
   x input.html.twig
-->
            <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
            <input class="webform-button--submit button button--primary js-form-submit form-submit" data-drupal-selector="edit-actions-submit-9" data-disable-refocus="true" type="submit" id="edit-actions-submit--9" name="op" value="Submit"
              data-once="drupal-ajax">
            <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
            <!-- END OUTPUT from 'modules/contrib/webform/templates/webform-actions.html.twig' -->
          </div>
          <!-- END OUTPUT from 'themes/custom/front/templates/container.html.twig' -->
        </div>
      </div>
    </div>
  </div>
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'input__hidden' -->
  <!-- FILE NAME SUGGESTIONS:
   * input--hidden.html.twig
   x input.html.twig
-->
  <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  <input autocomplete="off" data-drupal-selector="form-vtib5at0yu-xvkemuee3bdcszetokrkbs9wlogay2y0" type="hidden" name="form_build_id" value="form-vtib5AT0Yu_xVKeMUee3BdCsZEtOKrkbS9WLOgay2Y0">
  <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  <!-- THEME DEBUG -->
  <!-- THEME HOOK: 'input__hidden' -->
  <!-- FILE NAME SUGGESTIONS:
   * input--hidden.html.twig
   x input.html.twig
-->
  <!-- BEGIN OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  <input data-drupal-selector="edit-webform-submission-individual-life-node-15-add-form" type="hidden" name="form_id" value="webform_submission_individual_life_node_15_add_form">
  <!-- END OUTPUT from 'core/modules/system/templates/input.html.twig' -->
  <!-- END OUTPUT from 'modules/contrib/webform/templates/webform-submission-form.html.twig' -->
</form>

POST https://secure.mua.mu/travel/index.php?insurer=ke

<form action="https://secure.mua.mu/travel/index.php?insurer=ke" method="post" target="_blank" data-once="form-updated" data-drupal-form-fields=",,country_1" novalidate="novalidate">
  <div class="col_3">
    <select name="gender" id="" required="">
      <option value="" disabled="" selected="">TITLE * </option>
      <option value="Mr">Mr</option>
      <option value="Mrs">Mrs</option>
      <option value="Miss">Miss</option>
    </select>
  </div>
  <div class="col_3">
    <input type="text" placeholder="First Name *" name="firstname" required="">
  </div>
  <div class="col_3">
    <input type="text" placeholder="Surname *" name="surname" required="">
  </div>
  <div class="col_3">
    <input type="number" placeholder="MOBILE *" maxlength="10" minlength="7" name="mobile" required="">
  </div>
  <div class="col_3">
    <input type="email" placeholder="Email" name="email">
  </div>
  <div class="col_3">
    <select name="cover" id="">
      <option value="" disabled="" selected="">TYPE OF COVER YOU NEED </option>
      <option value="21">EASY GO AFRICA</option>
      <option value="22">EASY GO SCHENGEN</option>
      <option value="23">EASY GO WORLDWIDE </option>
      <option value="24">EASY GO STUDENT </option>
      <option value="25">EASY GO INBOUND </option>
    </select>
  </div>
  <div class="col_3">
    <select name="country_1" id="country_1" class="form-control country">
      <option value="" disabled="" selected="">Country you are travelling to </option>
      <option value="0" selected="">Worldwide</option>
      <option value="2">Afghanistan </option>
      <option value="3">Albania </option>
      <option value="4">Algeria </option>
      <option value="5">American Samoa </option>
      <option value="6">Andorra </option>
      <option value="7">Angola </option>
      <option value="8">Anguilla </option>
      <option value="9">Antarctica </option>
      <option value="10">Antigua &amp; Barbuda </option>
      <option value="11">Antilles </option>
      <option value="12">Arabia Saudi </option>
      <option value="13">Argentina </option>
      <option value="14">Armenia </option>
      <option value="15">Aruba </option>
      <option value="16">Australia </option>
      <option value="17">Austria </option>
      <option value="18">Azerbaijan </option>
      <option value="20">Bahrain </option>
      <option value="237">Bali </option>
      <option value="21">Bangladesh </option>
      <option value="22">Barbados </option>
      <option value="23">Belarus </option>
      <option value="24">Belgium </option>
      <option value="25">Belize </option>
      <option value="26">Benin </option>
      <option value="27">Bermuda </option>
      <option value="28">Bhutan </option>
      <option value="29">Bolivia </option>
      <option value="231">Bosnia and Herzegovina </option>
      <option value="30">Botswana </option>
      <option value="31">Bouvet Island </option>
      <option value="32">Brazil </option>
      <option value="33">Brunei Darussalam </option>
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Mauritius, the Mauritius Port Office has restricted its international postal
service to France.
learn more
MUA launches its new three-year strategic plan
Regional insurance group MUA has officially launched its next three-year
Strategic Plan, at an event yesterday evening.
learn more
AGENCY MEETING
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End Of The Year Party
learn more
MESSAGE TO MUA SHAREHOLDERS
MUA LTD - SHAREHOLDERS RESIDING OUTSIDE MAURITIUS
Please note that due to current reduction in international flights to and from
Mauritius, the Mauritius Port Office has restricted its international postal
service to France.
learn more
MUA launches its new three-year strategic plan
Regional insurance group MUA has officially launched its next three-year
Strategic Plan, at an event yesterday evening.
learn more
AGENCY MEETING
learn more
End Of The Year Party
learn more
MESSAGE TO MUA SHAREHOLDERS
MUA LTD - SHAREHOLDERS RESIDING OUTSIDE MAURITIUS
Please note that due to current reduction in international flights to and from
Mauritius, the Mauritius Port Office has restricted its international postal
service to France.
learn more
MUA launches its new three-year strategic plan
Regional insurance group MUA has officially launched its next three-year
Strategic Plan, at an event yesterday evening.
learn more

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