34.126.153.33 Open in urlscan Pro
34.126.153.33  Public Scan

Form analysis
1 forms found in the DOM

POST

<form action="" method="post" id="form_data" enctype="multipart/form-data" class="needs-validation" novalidate="">
  <input type="hidden" name="csrfmiddlewaretoken" value="vYN234FbKJ8fNY0rDIZmTMEb270kr6y9YGUbRHhNS9cFFJHDf8waqgzcB4m813uS">
  <img src="https://cms.bug2mobile.com/uploads/large_S_41762840_65bedc309d.jpg" class="img-thumbnail" alt="Responsive image">
  <div class="form-group">
    <label for="exampleFormControlInput1">First Name</label>
    <input type="text" class="form-control" id="firstName" placeholder="FirstName" maxlength="30">
    <div class="valid-tooltip"> Looks good! </div>
  </div>
  <div class="form-group">
    <label for="exampleFormControlInput1">Last Name</label>
    <input type="text" class="form-control" id="lastName" placeholder="LastName">
  </div>
  <div class="form-group">
    <label for="exampleFormControlInput1">Tel</label>
    <input type="tel" class="form-control" id="tel" placeholder="08x-xxx-xxxx">
  </div>
  <div class="form-group">
    <label for="exampleFormControlInput1">Email address</label>
    <input type="email" class="form-control" id="email" placeholder="name@example.com">
  </div>
  <div class="form-group">
    <label for="exampleFormControlSelect1">Example select</label>
    <select class="form-control" id="packagePrice">
      <option>199</option>
      <option>299</option>
      <option>399</option>
    </select>
  </div>
  <div class="form-group">
    <label for="exampleFormControlTextarea1">Example textarea</label>
    <textarea class="form-control" id="txtNote" rows="3"></textarea>
  </div>
  <div class="form-group">
    <label for="exampleFormControlFile1">Example file input</label>
    <input type="file" class="form-control-file" id="paySlip" name="paySlip01">
  </div>
  <button id="btnSubmitForm" type="button" class="btn btn-primary">Submit</button>
</form>

Text Content

Kbank
First Name
Looks good!
Last Name
Tel
Email address
Example select 199 299 399
Example textarea
Example file input
Submit
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Lucky Heng Heng