isanet.sahamtg.com
Open in
urlscan Pro
41.207.186.116
Public Scan
URL:
http://isanet.sahamtg.com:8036/centre/choix_sous_actes_ts.php?sact=2&&cdnp=aims&&ctr=c13029&&agc=dedji&&lg=%rf&&bp=35082&&plc=1...
Submission: On November 01 via api from US — Scanned from DE
Submission: On November 01 via api from US — Scanned from DE
Form analysis 3 forms found in the DOM
Name: form2 — POST
<form id="form2" name="form2" method="post" action=""> <br>
<div align="center"><strong>
<font size="3.5" color="#FF0000"><img src="../images/fleche4.jpg" width="70" height="12" alt="">:</font>
</strong> ; <input name="rech_sous_actes" type="text" id="rech_sous_actes" class="highlight3">
<input type="submit" name="Submit" class="formbouton" value=" ">
<input type="hidden" name="sact" value="">
<input type="hidden" name="cdnp" value="">
<input type="hidden" name="ctr" value="c13029">
<input type="hidden" name="agc" value="dedji">
<input type="hidden" name="bp" value="35082">
<input type="hidden" name="plc" value="159">
<input type="hidden" name="dic" value="gk110">
</div>
</form>Name: frm — POST
<form id="form1" name="frm" method="post" action="">
<table width="100%" border="0" cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td>
<p> </p>
<div align="center"></div>
<table width="633" border="0" align="right" cellpadding="0" cellspacing="0" overflow:auto="">
<tbody>
<tr bgcolor="darkblue">
<td height="25" bgcolor="darkblue">
<div align="center"><strong><span class="Style8"></span></strong></div>
<div align="center"></div>
</td>
<td bgcolor="DARKBLUE">
<div align="center" class="Style30"><strong></strong></div>
</td>
<td bgcolor="DARKBLUE">
<div align="center" class="Style27"></div>
</td>
<td bgcolor="DARKBLUE">
<div align="center" class="Style27"></div>
</td>
<td bgcolor="DARKBLUE">
<div align="center" class="Style29"><strong></strong></div>
</td>
</tr>
<tr bgcolor="LightSkyBlue">
<td width="38" bgcolor="LightSkyBlue">
<div align="left">
<input type="checkbox" name="mat[]" id="mat" value="5000" onclick="UpdateCost()">
</div>
<div align="center"></div>
</td>
<td width="253" bgcolor="LightSkyBlue">
<div align="left"><span class="Style7">AUTOREFRACTOMETRIE</span>
<input type="hidden" name="test2" id="test2">
</div>
</td>
<td width="17" bgcolor="LightSkyBlue">
<div align="left">
<p> </p>
<p>
<input name="textfield" type="hidden" value="">
</p>
</div>
</td>
<td width="24" bgcolor="LightSkyBlue"><input name="textfield2" type="hidden" value=""></td>
<td width="249" bgcolor="LightSkyBlue">
<div align="center">
<input name="montacte" type="text" class="highlight" id="montacte" value="5 000" size="5" readonly="true">
<input type="hidden" name="vrai_montant" id="vrai_montant" value="5000">
<input type="hidden" name="qte_te[]" id="qte" value="1">
</div>
</td>
</tr>
<tr>
<td>
<div align="left"></div>
<div align="center"></div>
</td>
<td>
<div align="center">
</div>
</td>
<td>
<div align="left">
<input name="affi" type="hidden" id="affi" value="">
</div>
</td>
<td>
<div align="left"></div>
</td>
<td>
<div align="left"></div>
</td>
</tr>
<tr bgcolor="LightSkyBlue">
<td width="38" bgcolor="LightSkyBlue">
<div align="left">
<input type="checkbox" name="mat[]" id="mat" value="12500" onclick="UpdateCost()">
</div>
<div align="center"></div>
</td>
<td width="253" bgcolor="LightSkyBlue">
<div align="left"><span class="Style7">CHAMP VISUEL AUTO</span>
<input type="hidden" name="test2" id="test2">
</div>
</td>
<td width="17" bgcolor="LightSkyBlue">
<div align="left">
<p> </p>
<p>
<input name="textfield" type="hidden" value="">
</p>
</div>
</td>
<td width="24" bgcolor="LightSkyBlue"><input name="textfield2" type="hidden" value=""></td>
<td width="249" bgcolor="LightSkyBlue">
<div align="center">
<input name="montacte" type="text" class="highlight" id="montacte" value="12 500" size="5" readonly="true">
<input type="hidden" name="vrai_montant" id="vrai_montant" value="12500">
<input type="hidden" name="qte_te[]" id="qte" value="1">
</div>
</td>
</tr>
<tr>
<td>
<div align="left"></div>
<div align="center"></div>
</td>
<td>
<div align="center">
</div>
</td>
<td>
<div align="left">
<input name="affi" type="hidden" id="affi" value="">
</div>
</td>
<td>
<div align="left"></div>
</td>
<td>
<div align="left"></div>
</td>
</tr>
<tr bgcolor="LightSkyBlue">
<td width="38" bgcolor="LightSkyBlue">
<div align="left">
<input type="checkbox" name="mat[]" id="mat" value="35000" onclick="UpdateCost()">
</div>
<div align="center"></div>
</td>
<td width="253" bgcolor="LightSkyBlue">
<div align="left"><span class="Style7">OCTPAPILLE GCC/MACULA</span>
<input type="hidden" name="test2" id="test2">
</div>
</td>
<td width="17" bgcolor="LightSkyBlue">
<div align="left">
<p> </p>
<p>
<input name="textfield" type="hidden" value="">
</p>
</div>
</td>
<td width="24" bgcolor="LightSkyBlue"><input name="textfield2" type="hidden" value=""></td>
<td width="249" bgcolor="LightSkyBlue">
<div align="center">
<input name="montacte" type="text" class="highlight" id="montacte" value="35 000" size="5" readonly="true">
<input type="hidden" name="vrai_montant" id="vrai_montant" value="35000">
<input type="hidden" name="qte_te[]" id="qte" value="1">
</div>
</td>
</tr>
<tr>
<td>
<div align="left"></div>
<div align="center"></div>
</td>
<td>
<div align="center">
</div>
</td>
<td>
<div align="left">
<input name="affi" type="hidden" id="affi" value="">
</div>
</td>
<td>
<div align="left"></div>
</td>
<td>
<div align="left"></div>
</td>
</tr>
<tr bgcolor="LightSkyBlue">
<td width="38" bgcolor="LightSkyBlue">
<div align="left">
<input type="checkbox" name="mat[]" id="mat" value="5000" onclick="UpdateCost()">
</div>
<div align="center"></div>
</td>
<td width="253" bgcolor="LightSkyBlue">
<div align="left"><span class="Style7">PACHYMETRIE</span>
<input type="hidden" name="test2" id="test2">
</div>
</td>
<td width="17" bgcolor="LightSkyBlue">
<div align="left">
<p> </p>
<p>
<input name="textfield" type="hidden" value="">
</p>
</div>
</td>
<td width="24" bgcolor="LightSkyBlue"><input name="textfield2" type="hidden" value=""></td>
<td width="249" bgcolor="LightSkyBlue">
<div align="center">
<input name="montacte" type="text" class="highlight" id="montacte" value="5 000" size="5" readonly="true">
<input type="hidden" name="vrai_montant" id="vrai_montant" value="5000">
<input type="hidden" name="qte_te[]" id="qte" value="1">
</div>
</td>
</tr>
<tr>
<td>
<div align="left"></div>
<div align="center"></div>
</td>
<td>
<div align="center">
</div>
</td>
<td>
<div align="left">
<input name="affi" type="hidden" id="affi" value="">
</div>
</td>
<td>
<div align="left"></div>
</td>
<td>
<div align="left"></div>
</td>
</tr>
<tr bgcolor="LightSkyBlue">
<td width="38" bgcolor="LightSkyBlue">
<div align="left">
<input type="checkbox" name="mat[]" id="mat" value="15000" onclick="UpdateCost()">
</div>
<div align="center"></div>
</td>
<td width="253" bgcolor="LightSkyBlue">
<div align="left"><span class="Style7">PHOTOPAPILLE</span>
<input type="hidden" name="test2" id="test2">
</div>
</td>
<td width="17" bgcolor="LightSkyBlue">
<div align="left">
<p> </p>
<p>
<input name="textfield" type="hidden" value="">
</p>
</div>
</td>
<td width="24" bgcolor="LightSkyBlue"><input name="textfield2" type="hidden" value=""></td>
<td width="249" bgcolor="LightSkyBlue">
<div align="center">
<input name="montacte" type="text" class="highlight" id="montacte" value="15 000" size="5" readonly="true">
<input type="hidden" name="vrai_montant" id="vrai_montant" value="15000">
<input type="hidden" name="qte_te[]" id="qte" value="1">
</div>
</td>
</tr>
<tr>
<td>
<div align="left"></div>
<div align="center"></div>
</td>
<td>
<div align="center">
</div>
</td>
<td>
<div align="left">
<input name="affi" type="hidden" id="affi" value="">
</div>
</td>
<td>
<div align="left"></div>
</td>
<td>
<div align="left"></div>
</td>
</tr>
<tr bgcolor="LightSkyBlue">
<td width="38" bgcolor="LightSkyBlue">
<div align="left">
<input type="checkbox" name="mat[]" id="mat" value="15000" onclick="UpdateCost()">
</div>
<div align="center"></div>
</td>
<td width="253" bgcolor="LightSkyBlue">
<div align="left"><span class="Style7">PHOTORETINE</span>
<input type="hidden" name="test2" id="test2">
</div>
</td>
<td width="17" bgcolor="LightSkyBlue">
<div align="left">
<p> </p>
<p>
<input name="textfield" type="hidden" value="">
</p>
</div>
</td>
<td width="24" bgcolor="LightSkyBlue"><input name="textfield2" type="hidden" value=""></td>
<td width="249" bgcolor="LightSkyBlue">
<div align="center">
<input name="montacte" type="text" class="highlight" id="montacte" value="15 000" size="5" readonly="true">
<input type="hidden" name="vrai_montant" id="vrai_montant" value="15000">
<input type="hidden" name="qte_te[]" id="qte" value="1">
</div>
</td>
</tr>
<tr>
<td>
<div align="left"></div>
<div align="center"></div>
</td>
<td>
<div align="center">
</div>
</td>
<td>
<div align="left">
<input name="affi" type="hidden" id="affi" value="">
</div>
</td>
<td>
<div align="left"></div>
</td>
<td>
<div align="left"></div>
</td>
</tr>
<tr bgcolor="LightSkyBlue">
<td width="38" bgcolor="LightSkyBlue">
<div align="left">
<input type="checkbox" name="mat[]" id="mat" value="5000" onclick="UpdateCost()">
</div>
<div align="center"></div>
</td>
<td width="253" bgcolor="LightSkyBlue">
<div align="left"><span class="Style7">PRESSION INTRA OCCULAIRE</span>
<input type="hidden" name="test2" id="test2">
</div>
</td>
<td width="17" bgcolor="LightSkyBlue">
<div align="left">
<p> </p>
<p>
<input name="textfield" type="hidden" value="">
</p>
</div>
</td>
<td width="24" bgcolor="LightSkyBlue"><input name="textfield2" type="hidden" value=""></td>
<td width="249" bgcolor="LightSkyBlue">
<div align="center">
<input name="montacte" type="text" class="highlight" id="montacte" value="5 000" size="5" readonly="true">
<input type="hidden" name="vrai_montant" id="vrai_montant" value="5000">
<input type="hidden" name="qte_te[]" id="qte" value="1">
</div>
</td>
</tr>
<tr>
<td>
<div align="left"></div>
<div align="center"></div>
</td>
<td>
<div align="center">
</div>
</td>
<td>
<div align="left">
<input name="affi" type="hidden" id="affi" value="">
</div>
</td>
<td>
<div align="left"></div>
</td>
<td>
<div align="left"></div>
</td>
</tr>
</tbody>
</table>
<div align="right"></div>
<div align="center"></div>
<p align="center">
<input name="sacte" type="hidden" id="sacte" value="2">
<input name="code_nomenp" type="hidden" id="code_nomenp" value="aims">
<input name="ctr_hospi" type="hidden" id="ctr_hospi" value="c13029">
<input name="agent" type="hidden" id="agent" value="dedji">
<input name="test" type="hidden" id="test">
</p>
<p align="center">
<input type="hidden" name="resultat" id="resultat">
<input name="coche" type="submit" class="formbouton" id="coche" value="Afficher Montant" style="visibility:hidden">
<input type="hidden" name="afficher" id="totalcost">
</p>
</td>
</tr>
</tbody>
</table>
</form>POST ../centre/portail_bio_ts.php?sact=2&&ctr=c13029&&agc=dedji&&cdnp=aims&&plc=159&&dic=gk110&&pg=a&&tq=&&ch=v_b
<form action="../centre/portail_bio_ts.php?sact=2&&ctr=c13029&&agc=dedji&&cdnp=aims&&plc=159&&dic=gk110&&pg=a&&tq=&&ch=v_b" method="post">
<br><br>
<div align="center">
<font color="red" size="2.5" weight="bold"></font>
<input name="montant2" size="6" type="text" class="highlight3" id="montant2" readonly="true">
<input name="rech_pat_r" type="hidden" id="rech_pat_r" value="35082">
<input name="med_exec" type="hidden" id="med_exec" value="gk110">
<input name="montant" type="hidden" id="montant">
<input type="hidden" name="pladond_acte" id="plafond_acte" value="999999999999">
<input type="hidden" name="tot_checkbox" id="tot_checkbox" value="">
<font color="green" size="2.5" weight="bold"></font>
<input type="HIDDEN" class="highlight2" name="solder" id="solde" value="999999999999" size="12" readonly="true">
<input type="hidden" name="af_qte" id="afi_qte">
<br>
<input type="hidden" name="matbenef" value="35082">
<br><br><br>
<table width="698" border="0">
<tbody>
<tr>
<td width="15" bordercolor="0"> </td>
<td width="15" bordercolor="0"> </td>
<td width="60" bordercolor="0"> </td>
<td width="143" bordercolor="0">
<div align="center"></div>
</td>
<td width="134" bordercolor="0">
<div align="right">
<input name="Submit2" type="submit" class="formbouton" value=" " onclick="javascript: return verif();">
</div>
</td>
<td width="44" bordercolor="0"> </td>
<td width="257" bordercolor="0"><input name="Submit322" type="button" class="formbouton"
onclick="MM_goToURL('parent','portail_bio_ts.php?sact=2&&bp2=35082&&agc=dedji&&pg=a&&tq=&&ch=v_b');return document.MM_returnValue" value=" "></td>
</tr>
</tbody>
</table>
</div>
</form>Text Content
SANLAM-TOGO SANLAM-TOGOO 1 de , 2024 Texte défilant d'Astwinds : ; AUTOREFRACTOMETRIE CHAMP VISUEL AUTO OCTPAPILLE GCC/MACULA PACHYMETRIE PHOTOPAPILLE PHOTORETINE PRESSION INTRA OCCULAIRE CopyRight (c) 2011- 2024 MCICARE COTE D'IVOIRE (06 BP 1309 ABIDJAN 06 Tél : (225) 27 20 31 65 00 /27 20 31 65 50 Fax : (225) 27 20 21 45 76/77)