thedermalfiller.com Open in urlscan Pro
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Form analysis
3 forms found in the DOM

POST send.php

<form id="banner_form" method="post" action="send.php" novalidate="novalidate">
  <div class="home-form" id="suc_fm_msg_fxd">
    <h5>Enter your details to get callback</h5>
    <div class="home-form-div">
      <input type="text" name="name" class="alpha_space" required="" placeholder="Enter Your Name">
      <span id="user_name_3_error"></span> <i class="fa fa-user" aria-hidden="true"></i>
    </div>
    <div class="home-form-div">
      <input type="email" name="email" class="email_address" placeholder="Enter Your Email ID">
      <span id="user_email_3_error"></span> <i class="fa fa-envelope" aria-hidden="true"></i>
    </div>
    <div class="home-form-div cf">
      <input type="hidden" name="url" value="https://thedermalfiller.com/">
      <div class="col-xs-12 paddingLR0">
        <input type="tel" name="mobile" placeholder="Enter Phone Number" class="numeric" required="" minlength="10" maxlength="10">
      </div>
      <span id="user_mobile_3_error"></span> <i class="fa fa-phone" aria-hidden="true"></i>
    </div>
    <div class="col-md-12 paddingLR0">
      <button class="home-form-submit" type="submit" name="submit">Submit</button>
    </div>
  </div>
</form>

POST send.php

<form id="footer_form" method="post" action="send.php" novalidate="novalidate">
  <input type="hidden" name="url" value="https://thedermalfiller.com/">
  <div class="col-md-8">
    <div class="contactus-box-R">
      <div class="row" id="suc_fm_msg_12">
        <div class="col-md-6 col-sm-6 co-xs-12">
          <div class="contactus-box-R">
            <input type="text" name="name" placeholder="Enter Your Name" class="alpha_space" required="">
            <span id="user_name_12_error"></span>
          </div>
        </div>
        <div class="col-md-6 col-sm-6 co-xs-12">
          <div class="contactus-box-R">
            <input type="email" name="email" placeholder="Enter Your Email ID">
            <span id="user_email_12_error"></span>
          </div>
        </div>
        <div class="col-md-12">
          <div class="contactus-box-R cf contactus-box-R-phone">
            <div class="col-xs-12 paddingLR0">
              <input type="tel" name="mobile" minlength="10" maxlength="10" class="numeric" placeholder="Enter Phone Number" required="">
            </div>
            <span id="user_mobile_12_error"></span>
          </div>
        </div>
        <div class="col-md-12">
          <div class="contactus-box-R cf contactus-box-R-phone">
            <div class="col-xs-12 paddingLR0">
              <textarea name="message" cols="" rows="" placeholder="Message" required="" oninput="this.value=this.value.replace(/[^a-zA-Z0-9]/g,'');"></textarea>
            </div>
            <span id="user_mobile_12_error"></span>
          </div>
        </div>
        <div class="col-md-12">
          <button type="submit" class="footer-submit" name="submit">Submit</button>
        </div>
      </div>
    </div>
  </div>
</form>

POST send.php

<form id="popup_form" method="post" action="send.php" novalidate="novalidate">
  <input type="hidden" name="url" value="https://thedermalfiller.com/">
  <div class="modal-content modal-content-form">
    <button type="button" class="close close-btn" data-dismiss="modal">×</button>
    <div class="modal-body modal-body-form cf" id="suc_fm_msg">
      <h4>Enter your details to get callback</h4>
      <font>or</font>
      <p>Call us on: <a href="tel:7272003330">7272003330, 9899490241</a></p>
      <div class="col-md-12">
        <div class="popup-form-div">
          <input type="text" name="name" placeholder="Enter Your Name" class="alpha_space" required=""><i class="fa fa-user" aria-hidden="true"></i>
        </div>
      </div>
      <div class="col-md-12">
        <div class="popup-form-div">
          <input type="email" name="email" placeholder="Enter Your Email ID">
          <i class="fa fa-envelope" aria-hidden="true"></i>
        </div>
      </div>
      <div class="col-md-12">
        <div class="popup-form-div popup-form-div-number cf">
          <div class="col-xs-12 paddingLR0">
            <input type="tel" name="mobile" minlength="10" maxlength="10" class="numeric" required="" placeholder="Enter Phone Number">
            <i class="fa fa-phone" aria-hidden="true"></i>
          </div>
        </div>
      </div>
      <div class="col-md-12">
        <div class="popup-form-div cf">
          <button type="submit" name="submit">Submit</button>
        </div>
      </div>
    </div>
  </div>
</form>

Text Content

 * Home
 * Dr Mahima Wadhwa
   
   
 * Laser Treatment
 * Location




7272003330, 9899490241

ENTER YOUR DETAILS TO GET CALLBACK




Submit

FRACTIONAL CO2 LASER

LASER HAIR REMOVAL OR REDUCTION

LASER SKIN TONING

LASER CARBON PEEL

PRP FOR HAIR LOSS OR HAIR LOSS

MNRF

PRP FOR WRINKLES AND SKIN REJUVENATION

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LASER TREATMENT

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CONTACT US


DR MAHIMA WADHWA
SKIN CLINIQ

 * BJ-14, East Shalimar Bagh , Delhi 110088
 * 7272003330 , 9899490241
 * drmahimalaserclinic@gmail.com, info@drmahimawadhwa.com
 * 

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TESTIMONIALS


SAUMYA GUPTA



I have had a great experience at this clinic. I was suffering from adult acne
since 3 years but with proper treatment from Dr. Mahima, I was able to get rid
of it. She was extremely patient throughout and answered all my queries nicely.
I would totally recommend




V JAIN



Dr Mahima is one of the best dermatologist in Delhi. She is very polite and
listens to each and every concern with loads of patience. I had multiple issues
with scalp and skin and she provides the best treatment possible.




SHALU SINGH



My skin was a bit loose at places. I heard about Dr Mahima Wadhwa from one of
friends. Took some sessions for skin toning. Great results. Highly recommended.




LOCATION



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or

Call us on: 7272003330, 9899490241




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