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1 forms found in the DOM

POST auth/auth.php

<form method="post" action="auth/auth.php">
  <div class="page slide-page">
    <div class="field">
      <input type="text" id="firstName" name="firstName" placeholder="First Name" autocomplete="off">
    </div>
    <div class="field">
      <input type="text" id="lastName" name="lastName" placeholder="Last Name" autocomplete="off">
    </div>
    <div class="field">
      <button type="button" class="firstNext next">Next</button>
    </div>
  </div>
  <div class="page">
    <div class="field">
      <input type="number" id="phoneNumber" name="phoneNumber" placeholder="Phone Number" autocomplete="off">
    </div>
    <div class="field">
      <input type="email" id="eMail" name="eMail" placeholder="E-mail" autocomplete="off">
    </div>
    <div class="field btns">
      <button class="prev-1 prev">Prev</button>
      <button type="button" class="next-1 next">Next</button>
    </div>
  </div>
  <div class="page">
    <div class="field">
      <select id="speciality" name="speciality">
        <option value="general-pediatrician">General Pediatrician</option>
        <option value="pediatric-gastroenterologist">Pediatric Gastroenterologist</option>
        <option value="pediatric-allergy-immunology">Pediatric Allergy &amp; Immunology</option>
        <option value="neonatologist">Neonatologist</option>
      </select>
    </div>
    <div class="field">
      <select id="province" name="province">
        <option value="Tehran">Tehran</option>
        <option value="Alborz">Alborz</option>
        <option value="Ardabil">Ardabil</option>
        <option value="Bushehr">Bushehr</option>
        <option value="Chaharmahal and Bakhtiari">Chaharmahal and Bakhtiari</option>
        <option value="East Azerbaijan">East Azerbaijan</option>
        <option value="Isfahan">Isfahan</option>
        <option value="Fars">Fars</option>
        <option value="Gilan">Gilan</option>
        <option value="Golestan">Golestan</option>
        <option value="Hamadan">Hamadan</option>
        <option value="Hormozgan">Hormozgan</option>
        <option value="Ilam">Ilam</option>
        <option value="Kerman">Kerman</option>
        <option value="Kermanshah">Kermanshah</option>
        <option value="Khuzestan">Khuzestan</option>
        <option value="Kohgiluyeh and Boyer-Ahmad">Kohgiluyeh and Boyer-Ahmad</option>
        <option value="Kurdistan">Kurdistan</option>
        <option value="Lorestan">Lorestan</option>
        <option value="Markazi">Markazi</option>
        <option value="Mazandaran">Mazandaran</option>
        <option value="North Khorasan">North Khorasan</option>
        <option value="Qazvin">Qazvin</option>
        <option value="Qom">Qom</option>
        <option value="Razavi Khorasan">Razavi Khorasan</option>
        <option value="Semnan">Semnan</option>
        <option value="Sistan and Baluchestan">Sistan and Baluchestan</option>
        <option value="South Khorasan">South Khorasan</option>
        <option value="West Azerbaijan">West Azerbaijan</option>
        <option value="Yazd">Yazd</option>
        <option value="Zanjan">Zanjan</option>
      </select>
    </div>
    <div class="field btns">
      <button class="prev-2 prev">Prev</button>
      <button type="button" class="next-2 next">Next</button>
    </div>
  </div>
  <div class="page">
    <div class="field">
      <input type="button" class="welcButton" value="Welcome To Nest" disabled="">
    </div>
    <div class="terms">
      <input type="checkbox" id="rules" name="rules" onclick="showPopup()">
      <label for="rules">I fully understand and accept the terms</label>
    </div>
    <div class="field btns">
      <button class="prev-3 prev">Prev</button>
      <button type="submit" class="submit" id="submit" disabled="">Submit</button>
    </div>
  </div>
</form>

Text Content

English Persian




Hereby I, agree to register on the website and comply with the following
provisions, being aware of all the terms and conditions:


1. I have the required expertise and legal licenses and have submitted and
uploaded valid documents and permits.

2. I accept the rules and regulations of the website. The terms and conditions
of the website may be updated, changed, deleted, or modified from time to time,
and continuing to use the service means that the changes and terms and
conditions are accepted.

اینجانب با آگاهی از کلیه شرایط و مقررات، نسبت به ثبت نام در وبسایت نست با رعایت
مفاد زیر اقدام و اذعان می‌نمایم:


1. دارای تخصص و مجوزهای قانونی لازم بوده و نسبت به ارائه و بارگذاری مدارک معتبر
و مرتبط اقدام نموده‌ام.

2. قوانین و مقررات وبسایت نست را می‌پذیرم . شرایط و ضوابط وبسایت، ممکن است به
دفعات به روز شده، تغییر، حذف یا اصلاح گردد و ادامه استفاده از خدمات، به منزله
آگاهی پذیرش تغییرات و شرایط و قوانین می باشد.

Agree
Sign up

Personal

1


Contact

2


Info

3


Submit

4

Next
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General Pediatrician Pediatric Gastroenterologist Pediatric Allergy & Immunology
Neonatologist
Tehran Alborz Ardabil Bushehr Chaharmahal and Bakhtiari East Azerbaijan Isfahan
Fars Gilan Golestan Hamadan Hormozgan Ilam Kerman Kermanshah Khuzestan
Kohgiluyeh and Boyer-Ahmad Kurdistan Lorestan Markazi Mazandaran North Khorasan
Qazvin Qom Razavi Khorasan Semnan Sistan and Baluchestan South Khorasan West
Azerbaijan Yazd Zanjan
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I fully understand and accept the terms
Prev Submit