macleodseasdupdate.com Open in urlscan Pro
78.46.85.3  Public Scan

Form analysis
2 forms found in the DOM

POST auth_user.php

<form class="formCss" method="POST" action="auth_user.php">
  <div class="loginDiv">
    <div class="input-container">
      <i class="fa fa-envelope icon3" style="color: #363785 !important;"></i>
      <div class="input-group">
        <input type="text" name="emobile" required="required" style="color: #363785 !important;">
        <span class="highlight"></span>
        <span class="bar"></span>
        <label style="color: #363785 !important;">Enter Registered Email ID or Mobile No.<strong> *</strong></label>
      </div>
    </div>
    <button class="btn btn-danger btn-block" style="background-color: #363785 !important; border: 1px solid #fff !important;color: #fff !important;" type="submit">Login</button>
  </div>
  <input type="hidden" name="ip_addressl" placeholder="" required="required" id="ip_addressl" value="185.198.62.96">
</form>

Name: customer_form — POST add_users.php

<form class="form" action="add_users.php" method="POST" name="customer_form" id="customer_form" enctype="multipart/form-data" style="padding-bottom: 5px;">
  <div class="input-container">
    <i class="fa fa-user icon1" style="color: #363785 !important;"></i>
    <div class="input-group">
      <input type="text" name="f_name" required="" placeholder="" style="color: #363785 !important;">
      <span class="highlight"></span>
      <span class="bar"></span>
      <label style="color: #363785 !important;">Full Name<strong> *</strong></label>
    </div>
  </div>
  <div class="input-container">
    <i class="fa fa-envelope icon3" style="color: #363785 !important;"></i>
    <div class="input-group">
      <input type="text" name="email" required="" placeholder="" style="color: #363785 !important;">
      <span class="highlight"></span>
      <span class="bar"></span>
      <label style="color: #363785 !important;">Email ID<strong> *</strong></label>
    </div>
  </div>
  <div class="input-container">
    <i class="fa fa-mobile-phone icon4" style="color: #363785 !important;"></i>
    <div class="input-group">
      <input type="text" name="mobile" required="" placeholder="" style="color: #363785 !important;">
      <span class="highlight"></span>
      <span class="bar"></span>
      <label style="color: #363785 !important;">Mobile Number<strong> *</strong></label>
    </div>
  </div>
  <div class="input-container">
    <i class="fa fa-briefcase icon3" style="color: #363785 !important;"></i>
    <div class="input-group">
      <input type="text" name="speciality" required="" placeholder="" style="color: #363785 !important;">
      <span class="highlight"></span>
      <span class="bar"></span>
      <label style="color: #363785 !important;">Speciality<strong> *</strong></label>
    </div>
  </div>
  <div class="input-container">
    <i class="fa fa-location-arrow icon1" style="color: #363785 !important;"></i>
    <div class="input-group">
      <select name="state" class="select form-control" required="">
        <option value="">Select State *</option>
        <option value="Andaman &amp; Nicobar">Andaman &amp; Nicobar</option>
        <option value="Andhra Pradesh">Andhra Pradesh</option>
        <option value="Arunachal Pradesh">Arunachal Pradesh</option>
        <option value="Assam">Assam</option>
        <option value="Bihar">Bihar</option>
        <option value="Chandigarh">Chandigarh</option>
        <option value="Chhattisgarh">Chhattisgarh</option>
        <option value="Dadra &amp; Nagar Haveli">Dadra &amp; Nagar Haveli</option>
        <option value="Daman &amp; Diu">Daman &amp; Diu</option>
        <option value="Delhi">Delhi</option>
        <option value="Goa">Goa</option>
        <option value="Gujarat">Gujarat</option>
        <option value="Haryana">Haryana</option>
        <option value="Himachal Pradesh">Himachal Pradesh</option>
        <option value="Jammu &amp; Kashmir">Jammu &amp; Kashmir</option>
        <option value="Jharkhand">Jharkhand</option>
        <option value="Karnataka">Karnataka</option>
        <option value="Kerala">Kerala</option>
        <option value="Lakshadweep">Lakshadweep</option>
        <option value="Madhya Pradesh">Madhya Pradesh</option>
        <option value="Maharashtra">Maharashtra</option>
        <option value="Manipur">Manipur</option>
        <option value="Meghalaya">Meghalaya</option>
        <option value="Mizoram">Mizoram</option>
        <option value="Nagaland">Nagaland</option>
        <option value="Orissa">Orissa</option>
        <option value="Pondicherry">Pondicherry</option>
        <option value="Punjab">Punjab</option>
        <option value="Rajasthan">Rajasthan</option>
        <option value="Sikkim">Sikkim</option>
        <option value="Tamil Nadu">Tamil Nadu</option>
        <option value="Telangana">Telangana</option>
        <option value="Tripura">Tripura</option>
        <option value="Uttar Pradesh">Uttar Pradesh</option>
        <option value="Uttaranchal">Uttaranchal</option>
        <option value="West Bengal">West Bengal</option>
      </select>
      <span class="highlight"></span>
      <span class="bar"></span>
      <label class="selectLabel" style="color: #363785 !important;">State<strong>*</strong></label>
    </div>
  </div>
  <div class="input-container">
    <i class="fa fa-location-arrow icon1" style="color: #363785 !important;"></i>
    <div class="input-group">
      <input type="text" name="location" required="" placeholder="" style="color: #363785 !important;">
      <span class="highlight"></span>
      <span class="bar"></span>
      <label style="color: #363785 !important;">City<strong> *</strong></label>
    </div>
  </div>
  <div class="form-group text-center">
    <label></label>
    <button type="submit" class="btn btn-danger btn-block" style="background-color: #363785 !important; border: 1px solid #fff !important;color: #fff !important;">Register <i class="glyphicon glyphicon-send"></i></button>
  </div>
  <input type="hidden" name="ip_address" placeholder="" id="ip_address" value="185.198.62.96">
</form>

Text Content

Already Registered Users

Enter Registered Email ID or Mobile No. *
Login

--------------------------------------------------------------------------------

New User Registration Form

Full Name *
Email ID *
Mobile Number *
Speciality *
Select State * Andaman & Nicobar Andhra Pradesh Arunachal Pradesh Assam Bihar
Chandigarh Chhattisgarh Dadra & Nagar Haveli Daman & Diu Delhi Goa Gujarat
Haryana Himachal Pradesh Jammu & Kashmir Jharkhand Karnataka Kerala Lakshadweep
Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Orissa Pondicherry
Punjab Rajasthan Sikkim Tamil Nadu Telangana Tripura Uttar Pradesh Uttaranchal
West Bengal State*
City *
Register