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34.93.190.81  Public Scan

URL: https://rt.clinicaltrac.net/school/cvccnc/clinician/index.html
Submission: On September 11 via manual from US — Scanned from DE

Form analysis 1 forms found in the DOM

POST clinicianLoginsubmit.html

<form accept-charset="UTF-8" id="frmLogin" data-parsley-validate="" method="post" action="clinicianLoginsubmit.html" novalidate="">
  <input type="hidden" name="attempt" id="attempt" value="MA==">
  <fieldset>
    <div class="form-group">
      <input class="form-control" placeholder="Username" required="" name="txtUsername" type="text" value="">
    </div>
    <div class="form-group">
      <input class="form-control" placeholder="Password" required="" name="txtPassword" type="password" value="">
    </div>
    <div class="form-group">
      <input class="btn btn-lg btn-blue btn-block" type="submit" name="btnLogin" value="Login">
    </div>
    <div class="row margin_zero forgot-password text-center myclass">
      <a href="forgotpassword.html">Forgot password?</a>
    </div>
  </fieldset>
</form>

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Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem
Ipsum has been the industry's standard dummy text ever since the 1500s, when an
unknown printer took a galley of type and scrambled it to make a type specimen
book. It has survived not only five centuries, but also the leap into electronic
typesetting, remaining essentially unchanged. It was popularised in the 1960s
with the release of Letraset sheets containing Lorem Ipsum passages, and more
recently with desktop publishing software like Aldus PageMaker including
versions of Lorem Ipsum

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