www.antrianrawatjalan.hasanahgraha.xyz Open in urlscan Pro
103.147.154.134  Public Scan

Submitted URL: https://www.antrianrawatjalan.hasanahgraha.xyz/
Effective URL: https://www.antrianrawatjalan.hasanahgraha.xyz/login.php
Submission: On September 23 via automatic, source certstream-suspicious — Scanned from DE

Form analysis 1 forms found in the DOM

POST

<form method="POST">
  <div class="form-floating mb-3">
    <input class="form-control" type="email" id="email" name="email" placeholder="name@example.com" required="">
    <label>Masukkan Email</label>
  </div>
  <div class="form-floating mb-3">
    <input class="form-control" type="password" id="no_ktp" name="no_ktp" placeholder="No KTP" required="">
    <label>Masukkan Password</label>
  </div>
  <div class="form-floating mb-3">
    <input class="form-control" type="hidden" id="nama_pasien" name="nama_pasien">
  </div>
  <div class="d-flex justify-content-around">
    <input class="btn fourth" type="submit" name="login" value="Masuk">
  </div>
</form>

Text Content

SILAHKAN MASUK

Masukkan Email
Masukkan Password


Pasien Baru? Registrasi Sekarang!