eclaims-uat.unog.ch Open in urlscan Pro
193.239.220.14  Public Scan

Form analysis
1 forms found in the DOM

Name: loginForm — POST /login/authenticate

<form action="/login/authenticate" method="POST" id="loginForm" name="loginForm" autocomplete="off">
  <input type="hidden" value="false" name="returning" id="returning">
  <div class="row pb-2">
    <div class="pl-3 col-10">
      <div class="input-group">
        <div class="col-1">
          <i class="fal fa-address-card fa-lg pt-3"></i>
        </div>
        <input type="text" id="insurancenumber" name="insurancenumber" maxlength="6" tabindex="1" onkeypress="return isNumber(event)" class="col-11	ml-4 rounded-0 border-top-0 border-left-0 border-right-0 border-dark form-control"
          placeholder="Insurance Number" required="">
      </div>
    </div>
    <div class="col-2 pl-3 pt-2">
      <a href="#" data-toggle="modal" data-target="#modalDialog1"><i class="fal fa-info-circle fa-lg"></i></a>
    </div>
    <div class="pl-3 pt-3 col-12 input-group">
      <div class="col-1">
        <i class="fal fa-user fa-lg pt-3"></i>
      </div>
      <input type="text" id="username" name="username" tabindex="2" size="20" class="col-11	mx-3 rounded-0 border-top-0 border-left-0 border-right-0 border-dark form-control" placeholder="Username" required="">
    </div>
    <div class="pl-3 py-3 col-12 input-group">
      <div class="col-1">
        <i id="lock-icon" class="fal fa-lock-alt fa-lg pt-3"></i>
      </div>
      <input type="password" id="password" name="password" tabindex="3" class="col-11 mx-3 rounded-0 border-top-0 border-left-0 border-right-0 border-dark form-control" placeholder="Password" required="">
      <span toggle="#password-field" class="fal fa-fw fa-eye field_icon toggle-password"></span>
    </div>
  </div>
  <button class="btn btn-primary btn-block" tabindex="4" type="submit"><i class="fal fa-sign-in pr-1"></i> Log in</button>
</form>

Text Content

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[ UAT ENVIRONMENT ]


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WHAT IS MY INSURANCE NUMBER?

This is the 6 digit number you can find on your membership card (without the
trailing '00')




You can also find your insurance number on your reimbursement advice as shown
below:



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