www.drdwiwirasanjaya.polikita.com Open in urlscan Pro
2001:df7:5300:2::13  Public Scan

Form analysis
1 forms found in the DOM

POST https://www.drdwiwirasanjaya.polikita.com/home/login-act

<form action="https://www.drdwiwirasanjaya.polikita.com/home/login-act" method="post">
  <div class="body bg-gray">
    <div class="form-group">
      <input type="text" name="username" class="form-control login-input" placeholder="Username">
      <span class="text-danger"></span>
    </div>
    <div class="form-group">
      <input type="password" name="password" class="form-control login-input" placeholder="Password">
      <span class="text-danger"></span>
    </div>
  </div>
  <div class="footer">
    <button type="submit" class="btn btn-polikita btn-block"><i class="fa fa-sign-in"></i> Login</button>
    <div class="clearfix"></div>
  </div>
</form>

Text Content

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