service.dme.se Open in urlscan Pro
2.56.29.72  Public Scan

Submitted URL: https://nyservice.dme.se/
Effective URL: https://service.dme.se/NewReportCustomer/4/Zsaw124kdl98LJ
Submission: On August 24 via api from US — Scanned from SE

Form analysis 1 forms found in the DOM

POST ./Zsaw124kdl98LJ

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    <div class="row">
      <div class="col-md-3">
        <div class="page-header">
          <h3>Servicerapport</h3>
        </div> Har du flera enheter väljer du det på nästa sida, du skriver in en enhet per gång.&nbsp; <br>
      </div>
      <div class="col-md-3">
        <div class="page-header">
          <h3>Kontaktuppgifter</h3>
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        <div class="form-group">
          <label>Företag</label>
          <input name="TxtboxCompanyName" type="text" maxlength="50" id="TxtboxCompanyName" class="form-control">
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        <div class="form-group">
          <label>Namn</label>
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        <div class="form-group">
          <label>Adress</label>
          <input name="TxtboxCustomerAddress" type="text" maxlength="50" id="TxtboxCustomerAddress" class="form-control">
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        <div class="row">
          <div class="col-sm-5">
            <div class="form-group">
              <label>Postnr</label>
              <input name="TxtboxCustomerPostalNr" type="text" maxlength="6" id="TxtboxCustomerPostalNr" class="form-control">
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          </div>
          <div class="col-sm-7">
            <div class="form-group">
              <label>Postadress</label>
              <input name="TxtboxCustomerPostalAddress" type="text" maxlength="50" id="TxtboxCustomerPostalAddress" class="form-control">
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          </div>
        </div>
        <div class="form-group">
          <label>Mobil</label>
          <input name="TxtboxCustomerMobile" type="text" maxlength="50" id="TxtboxCustomerMobile" class="form-control">
          <span data-val-controltovalidate="TxtboxCustomerMobile" data-val-errormessage="Fyll i mobilnummer!" data-val-display="Dynamic" data-val-validationgroup="NewService" id="RequiredFieldValidatorTxtboxCustomerMobile"
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        <div class="form-group">
          <label>Telefon</label>
          <input name="TxtboxCustomerPhone" type="text" maxlength="50" id="TxtboxCustomerPhone" class="form-control">
        </div>
        <div class="form-group">
          <label>Email</label>
          <input name="TxtboxCustomerEmail" type="text" maxlength="50" id="TxtboxCustomerEmail" class="form-control">
          <span data-val-controltovalidate="TxtboxCustomerEmail" data-val-errormessage="Fyll i emailadress!" data-val-display="Dynamic" data-val-validationgroup="NewService" id="RequiredFieldValidatorTxtboxCustomerEmail" class="validationerror-text"
            data-val="true" data-val-evaluationfunction="RequiredFieldValidatorEvaluateIsValid" data-val-initialvalue="" style="display:none;">Fyll i emailadress!</span>
          <span data-val-controltovalidate="TxtboxCustomerEmail" data-val-errormessage="Felaktig emailadress!" data-val-display="Dynamic" data-val-validationgroup="NewService" id="RegularExpressionValidatorEamil" class="validationerror-text"
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      <div class="col-md-3">
        <div class="page-header">
          <h3>Produkt</h3>
        </div>
        <div class="form-group">
          <label>Fabrikat &amp; modell</label>
          <input name="TxtboxProduct" type="text" maxlength="50" id="TxtboxProduct" class="form-control">
          <span data-val-controltovalidate="TxtboxProduct" data-val-errormessage="Fyll i Apparatmodell!" data-val-display="Dynamic" data-val-validationgroup="NewService" id="ctl06" class="validationerror-text" data-val="true"
            data-val-evaluationfunction="RequiredFieldValidatorEvaluateIsValid" data-val-initialvalue="" style="display:none;">Fyll i Apparatmodell!</span>
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        <div class="form-group">
          <label>Medföljande tillbehör</label>
          <textarea name="TxtBoxAccessories" rows="5" cols="20" id="TxtBoxAccessories" class="form-control"></textarea>
          <span data-val-controltovalidate="TxtBoxAccessories" data-val-focusonerror="t" data-val-errormessage="Tillbehör max 200 tecken!" data-val-display="Dynamic" data-val-validationgroup="NewService" id="RegularExpressionValidator4"
            class="validationerror-text" data-val="true" data-val-evaluationfunction="RegularExpressionValidatorEvaluateIsValid" data-val-validationexpression="[\s\S]{0,200}$" style="display:none;">Tillbehör max 200 tecken!</span>
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        <div class="form-group">
          <label>Felbeskrivning</label>
          <textarea name="TxtboxErrorDescription" rows="10" cols="20" id="TxtboxErrorDescription" class="form-control"></textarea>
          <span data-val-controltovalidate="TxtboxErrorDescription" data-val-errormessage="Fyll i felbeskrivning!<br />" data-val-display="Dynamic" data-val-validationgroup="NewService" id="ctl07" class="validationerror-text" data-val="true"
            data-val-evaluationfunction="RequiredFieldValidatorEvaluateIsValid" data-val-initialvalue="" style="display:none;">Fyll i felbeskrivning!<br></span>
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      <div class="col-md-3">
        <div class="page-header">
          <h3>Garanti</h3>
        </div>
        <div class="form-group">
          <span class="checkbox"><input id="ChkboxWarranty" type="checkbox" name="ChkboxWarranty" onclick="javascript:setTimeout('__doPostBack(\'ChkboxWarranty\',\'\')', 0)"><label for="ChkboxWarranty">Garantiärende (Kvitto/faktura måste
              bifogas)</label></span>
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        <div id="PanelHasWarranty">
          <div class="form-group">
            <label>Fakturanummer</label>
            <input name="TxtboxInvoiceNo" type="text" maxlength="50" id="TxtboxInvoiceNo" class="form-control">
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          <div class="form-group">
            <label>Ordernummer</label>
            <input name="TxtBoxOrderNo" type="text" maxlength="50" id="TxtBoxOrderNo" class="form-control">
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            <label>Inköpt hos</label>
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          <div class="form-group">
            <label>Inköpsdatum</label>
            <input name="TxtboxPurcaseDate" type="text" maxlength="50" id="TxtboxPurcaseDate" class="form-control">
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        </div>
        <div class="page-header">
          <h3>Leveransmetod</h3>
        </div>
        <div class="form-group">
          <table id="RadioBtnListDeliveryMethod" class="radio-inline">
            <tbody>
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                <td><input id="RadioBtnListDeliveryMethod_0" type="radio" name="RadioBtnListDeliveryMethod" value="1" onclick="javascript:setTimeout('__doPostBack(\'RadioBtnListDeliveryMethod$0\',\'\')', 0)"><label
                    for="RadioBtnListDeliveryMethod_0">Lämnas / hämtas</label></td>
              </tr>
              <tr>
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            data-val-evaluationfunction="RequiredFieldValidatorEvaluateIsValid" data-val-initialvalue="" style="display:none;">Välj leverans metod</span>
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        <div class="row">
          <div class="col-md-12">
            <div data-val-headertext="Några av fälten är ej ifyllda!" data-val-displaymode="List" data-val-validationgroup="NewService" id="ValidationSummary1" class="validationerror-text" data-valsummary="true" style="display:none;">
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Text Content

SERVICERAPPORT

Har du flera enheter väljer du det på nästa sida, du skriver in en enhet per
gång. 



KONTAKTUPPGIFTER

Företag
Namn Fyll i namn!
Adress
Postnr
Postadress
Mobil Fyll i mobilnummer!
Telefon
Email Fyll i emailadress! Felaktig emailadress!


PRODUKT

Fabrikat & modell Fyll i Apparatmodell!
Medföljande tillbehör Tillbehör max 200 tecken!
Felbeskrivning Fyll i felbeskrivning!
Felbeskrivning max 500 tecken!
Beskriv felet så detaljerat du kan.


GARANTI

Garantiärende (Kvitto/faktura måste bifogas)
Fakturanummer
Ordernummer
Inköpt hos
Inköpsdatum


LEVERANSMETOD

Lämnas / hämtas Skickas


Välj leverans metod

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