instasaral.nivabupa.com Open in urlscan Pro
3.6.71.79  Public Scan

Form analysis
1 forms found in the DOM

POST

<form role="form" method="post" class="login-form" id="login-form">
  <input type="hidden" id="captchaRequired" value="yes">
  <input name="__RequestVerificationToken" type="hidden" value="bcM4mQrEeZX9a68_dzTXTToDXmRhRgNdXixTxB4mkEkfUoOy2EM9fQkFC8KHrs7vVNuecjWQt5-csfx9Y62M2nlUzdvCERu8SukoAsIl_rI1">
  <b style="color: red">
                        <div class="validation-summary-valid" data-valmsg-summary="true"><ul><li style="display:none"></li>
</ul></div>
                    </b>
  <div class="form-group has-feedback">
    <input autofocus="autofocus" class="form-control" data-val="true" data-val-required="Plaese enter username" id="UserName" name="UserName" placeholder="User Name" type="text" value="">
    <span class="glyphicon glyphicon-user form-control-feedback"></span>
    <span class="field-validation-valid" data-valmsg-for="UserName" data-valmsg-replace="true"></span>
  </div>
  <div class="form-group has-feedback">
    <input class="form-control" data-val="true" data-val-required="Plaese enter password" id="Password" name="Password" placeholder="Password" type="password">
    <span class="glyphicon glyphicon-lock form-control-feedback"></span>
    <span class="field-validation-valid" data-valmsg-for="Password" data-valmsg-replace="true"></span>
  </div>
  <div class="form-group has-feedback">
    <span id="captcha" style="padding: 5px; font-family:cursive; background: url('/Cypher/Images/captcha-background.jpg'); font-size: 25px;">34952</span> &nbsp; <span id="refresh" style="font-size:20px; cursor:pointer;"
      class="glyphicon glyphicon-refresh"></span>
  </div>
  <div class="form-group has-feedback">
    <label for="AuthorizationCode"><span style="color:red;">*</span>&nbsp;Enter above image text</label>
    <input type="text" class="form-control" id="AuthorizationCode" name="AuthorizationCode" placeholder="Enter Image Text">
  </div>
  <div class="row">
    <div class="col-md-6">
      <input type="button" value="Sign In" title="Sign In" id="btnLogin" class="btn btn-primary btn-block btn-flat" style="background-color:#0b5e41; border-color:#0b5e41;">
    </div>
    <div class="col-md-6">
      <a href="/Cypher/Account/ForgotPassword" title="Forgot Password?" data-toggle="tooltip">
                                Forgot Password?
                            </a>
    </div>
  </div>
  <br>
  <div class="row">
    <div class="col-md-12">
      <span class="pull-right"> Powered by <img src="/Cypher/Images/niva-logo.png" style="max-width: 65px" alt="">
      </span>
    </div>
  </div>
</form>

Text Content

 * 



34952  
* Enter above image text
Forgot Password?

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