patienthub-hhft.onmats.com Open in urlscan Pro
35.176.96.223  Public Scan

Form analysis
1 forms found in the DOM

POST login

<form method="post" action="login" class="loginform mobilebox login_step" data-required_fields_label="Not enough fields" novalidate="novalidate">
  <!-- templates/login/fields_group.php -->
  <style>
    body#page-login .fields_group .alert-danger {
      color: #FFC107;
      background-color: transparent;
      border-color: transparent;
    }

    body#page-login .fields_group .alert {
      position: relative;
      padding: 0;
      margin-bottom: 1rem;
      border: 1px solid transparent;
    }
  </style>
  <div class="fields_group mb-3" data-number_of_required_fields="2">
    <p></p>
    <div class="alert alert-danger hidden rounded" role="alert"></div>
    <!-- templates/login/input_wrapper.php -->
    <div class="input-group">
      <div class="input-group">
        <div class="input-group-text rounded-left">
          <i class="fas fa-mobile"></i>
        </div>
        <input name="authentication_flow[fields][0][0]" aria-label="Mobile number" class="form-control rounded-right valid_mobile" placeholder="Mobile number" autocomplete="off" data-areacode="0">
      </div>
    </div><!-- templates/login/input_wrapper.php -->
    <div class="input-group">
      <div class="input-group">
        <div class="input-group-text rounded-left">
          <i class="fas fa-calendar-alt"></i>
        </div>
        <input name="authentication_flow[fields][0][1]" aria-label="Date of birth" class="form-control rounded-right valid_date" placeholder="Date of birth" autocomplete="off">
      </div>
    </div>
  </div>
  <input type="hidden" name="authentication_flow[id]" value="AFL0000011DECAB1"><input type="hidden" name="authentication_flow[start_process]" value="1">
  <div class="row">
    <div class="col-12">
      <button type="submit" class="btn btn-primary px-4 mb-1 login_step_submit">Next</button>
    </div>
  </div>
</form>

Text Content

Patient Hub (2023.3.942)
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