simrs-poltek.kartinihospital.com Open in urlscan Pro
103.16.198.157  Public Scan

Form analysis
1 forms found in the DOM

POST https://simrs-poltek.kartinihospital.com/admin/

<form action="https://simrs-poltek.kartinihospital.com/admin/" method="POST">
  <div class="form-group">
    <div class="input-group">
      <div class="input-group-addon"><i class="fa fa-user"></i></div>
      <input type="text" name="username" class="form-control" placeholder="Nama Pengguna" required="">
    </div>
  </div>
  <div class="form-group">
    <div class="input-group">
      <div class="input-group-addon"><i class="fa fa-lock"></i></div>
      <input type="password" name="password" class="form-control" placeholder="Password" required="">
    </div>
  </div>
  <div class="form-group">
    <label class="remember-me pull-left">
      <input type="checkbox" name="remember_me" style="display: none;"><a href="#" class="toggle"></a> Ingat saya </label>
    <button type="submit" name="login" class="btn btn-primary pull-right">Sign In</button>
  </div>
</form>

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