www.officesafe.rma.com.my Open in urlscan Pro
51.79.135.220  Public Scan

Form analysis
1 forms found in the DOM

POST

<form method="post">
  <div class="form-group">
    <label>Sila Isi Nombor Telefon Mudah Alih Anda <br>Please Enter Your Mobile Phone Number <span class="text-danger">*</span></label>
    <input autocomplete="off" type="text" name="username" id="username" class="form-control" placeholder="Nombor Sahaja / Numbers Only " required="">
  </div>
  <div class="form-group">
    <label>Sila Isi Nama Anda <br> Please Enter Your Name <span class="text-danger">*</span></label>
    <input autocomplete="off" type="text" name="useremail" id="useremail" class="form-control" placeholder="Nama / Name" required="">
  </div>
  <div class="form-group">
    <label>Sila Isi Suhu Anda <br> Please Enter Your Temperature <span class="text-danger">*</span></label>
    <input autocomplete="off" type="text" class="tel form-control" name="userphone" id="userphone" placeholder="Nombor Sahaja / Numbers Only" required="">
  </div>
  <div class="form-group">
    <button type="submit" name="submit" value="submit" id="submit" class="btn btn-primary"><i class="fa fa-fw fa-plus-circle"></i> Register</button>
  </div>
</form>

Text Content

Register
Sila Isi Nombor Telefon Mudah Alih Anda
Please Enter Your Mobile Phone Number *
Sila Isi Nama Anda
Please Enter Your Name *
Sila Isi Suhu Anda
Please Enter Your Temperature *
Register