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Submitted URL: https://fhpl.co/k31tx57i
Effective URL: https://www.fhpl.net/HospitalRatingFeedback/HospitalRating_Survey.aspx?Id=nIIUeMVgiHFu~dZKGIzWuA==
Submission: On January 19 via manual from IN — Scanned from DE

Form analysis 1 forms found in the DOM

POST ./HospitalRating_Survey.aspx?Id=nIIUeMVgiHFu%7edZKGIzWuA%3d%3d

<form method="post" action="./HospitalRating_Survey.aspx?Id=nIIUeMVgiHFu%7edZKGIzWuA%3d%3d" id="ctl00">
  <div class="aspNetHidden">
    <input type="hidden" name="__VIEWSTATE" id="__VIEWSTATE"
      value="/wEPDwUKMjE0Mjc2MDU0Mg9kFgICAQ9kFgICBQ8WAh4JaW5uZXJodG1sBXo8aDMgc3R5bGU9J3RleHQtYWxpZ246Y2VudGVyOyBtYXJnaW4tdG9wOjIwJTsnPjxiPlRoYW5rIHlvdSBmb3Igc3VibWl0dGluZyB0aGUgc3VydmV5LCB5b3VyIGRldGFpbHMgYXJlIHJlY2lldmVkLjwvYj48L2gzPmRkMPlerjDWDuaLNvQcdt6mPyJx2ssHm775EJlp2nSg4xE=">
  </div>
  <div class="aspNetHidden">
    <input type="hidden" name="__VIEWSTATEGENERATOR" id="__VIEWSTATEGENERATOR" value="09DB05D3">
    <input type="hidden" name="__EVENTVALIDATION" id="__EVENTVALIDATION" value="/wEdAAJd62yd9f+1YJhXGQhRchh50QMu54r4Di0znCiTUP/xaql1fhri1qw+QFsfp1ueszx5G2dtsoBEoLwHZ6DKjykw">
  </div>
  <input type="hidden" name="hdnfldId" id="hdnfldId" value="264308">
  <div style="background-color:#f7f7f2;">
    <a href="#"><img src="images/footerlogo.png" id="LogoImg" class="img-responsive" style="width:180px;height:90px;padding:10px;"></a>
  </div>
  <div id="masterDiv" class="col-12">
    <h3 style="text-align:center; margin-top:20%;"><b>Thank you for submitting the survey, your details are recieved.</b></h3>
  </div>
</form>

Text Content

Hospital Rating Survey


THANK YOU FOR SUBMITTING THE SURVEY, YOUR DETAILS ARE RECIEVED.