www.lt.hostku.xyz Open in urlscan Pro
109.123.237.17  Public Scan

Form analysis
1 forms found in the DOM

POST

<form class="needs-validation" action="" method="POST">
  <p>
    <label for="namaDepan">Nama Depan:</label>
    <input type="text" class="form-control" name="nama_d" id="namaDepan" required="">
  </p>
  <p>
    <label for="namaBelakang">Nama Belakang:</label>
    <input type="text" class="form-control" name="nama_b" id="namaBelakang" required="">
  </p>
  <p>
    <label for="Kelamin">Jenis Kelamin:</label>
    <select class="form-select" aria-label="Default select example" name="kelamin" id="Kelamin">
      <option selected="">Pilih salah satu</option>
      <option value="Laki-laki">Laki-laki</option>
      <option value="Perempuan">Perempuan</option>
    </select>
    <!--<input type="text" class="form-control" name="kelamin" id="Kelamin" required> -->
  </p>
  <p>
    <label for=".datepicker" class="">Tanggal Lahir:</label>
  </p>
  <div class="input-group">
    <input type="date" class="form-control datepicker" name="lahir" id=".datepicker">
  </div>
  <p></p>
  <p>
    <label for="Alamat">Alamat:</label>
    <input type="text" class="form-control" name="alamat" id="Alamat" required="">
  </p>
  <p>
    <label for="Phone">Telp.:</label>
    <input type="tel" class="form-control" name="phone" id="Phone" required="">
  </p>
  <p>
    <label for="Email">Email:</label>
    <input type="email" class="form-control" name="email" id="Email" required="">
  </p>
  <p>
    <label for="Username">Username:</label>
    <input type="text" class="form-control" name="uname" id="Username" required="">
  </p>
  <p>
    <label for="Password">Password:</label>
    <input type="password" class="form-control" name="passwd" id="Password" required="">
  </p>
  <input type="submit" name="submit" value="Submit" id="btnSubmit">
</form>

Text Content

CUMA KANGGO LATIHAN BRO!


ISI FORMULIR

Nama Depan:

Nama Belakang:

Jenis Kelamin: Pilih salah satu Laki-laki Perempuan

Tanggal Lahir:





Alamat:

Telp.:

Email:

Username:

Password:


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