aqiqahklaten.dripform.id
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194.233.81.110
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URL:
https://aqiqahklaten.dripform.id/
Submission: On March 30 via api from US — Scanned from US
Submission: On March 30 via api from US — Scanned from US
Form analysis 1 forms found in the DOM
POST
<form method="POST" id="form-init">
<div class="px-6 py-3 bg-white">
<div class="editor-wrapper grid gap-3">
<h1><b><font color="#ef4444">PROMO PAKET AQIQAH TERBATAS!</font></b></h1>
</div>
</div>
<div class="px-6 py-3">
<div class="text-5xl md:text-6xl text-center flex w-full items-center justify-center">
<div class="bg-red-500 w-24 mx-1 p-2 text-white rounded-lg">
<div class="font-mono leading-none">00</div>
<div class="font-mono uppercase text-sm leading-none">Hari</div>
</div>
<div class="bg-red-500 w-24 mx-1 p-2 text-white rounded-lg">
<div class="font-mono leading-none">23</div>
<div class="font-mono uppercase text-sm leading-none">Jam</div>
</div>
<div class="bg-red-500 w-24 mx-1 p-2 text-white rounded-lg">
<div class="font-mono leading-none">59</div>
<div class="font-mono uppercase text-sm leading-none">Menit</div>
</div>
<div class="bg-red-500 w-24 mx-1 p-2 text-white rounded-lg">
<div class="font-mono leading-none">55</div>
<div class="font-mono uppercase text-sm leading-none">Detik</div>
</div>
</div>
</div>
<div class="px-6 py-6"><img src="https://setunggal.dripform.id/01adf531-5d3d-47e0-b9ba-ee40eef4b057.png" class="w-full" alt=""></div>
<div class="px-6 py-3 bg-orange-300">
<div class="mb-3 "><label class="block text-md font-semibold text-gray-700 mb-3 flex" for="">Nama Pemesan <span class="true text-red-400 ml-1">*</span></label> <input name="name" required=""
class="focus:outline-none focus:ring-2 focus:ring-green-900 focus:border-transparent block appearance-none p-3 w-full max-w-full mb-1 text-base leading-normal bg-white text-gray-800 border-none ring-1 ring-gray-300 rounded" type="text"
placeholder="Masukan Nama Anda"></div>
</div>
<div class="px-6 py-3">
<div class="mb-3"><label class="block text-md font-semibold text-gray-700 mb-3 flex" for="">Nomor WhataApp <span class="text-red-400 ml-1 true">*</span></label>
<div class="flex" v-if="selected_dial_code"><select
class="focus:outline-none focus:ring-2 focus:ring-green-900 focus:border-transparent rounded-r-none appearance-none p-3 mb-1 text-base leading-normal bg-white text-gray-800 border-none ring-1 ring-gray-300 rounded">
<option value="+ 345">+ 345</option>
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<option value="+994">+994</option>
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<option value="+996">+996</option>
<option value="+998">+998</option>
</select> <input name="phone" required=""
class="focus:outline-none focus:ring-2 focus:ring-green-900 focus:border-transparent block rounded-l-none appearance-none p-3 w-full max-w-full mb-1 text-base leading-normal bg-white text-gray-800 border-none ring-1 ring-gray-300 rounded"
type="text" placeholder="Masukkan Nomor Anda"></div>
</div>
</div>
<div class="px-6 py-3 bg-orange-300">
<div class="mb-4 pr-6"><label class="block text-md font-semibold text-gray-700 mb-3 flex" for="">Alamat<span class="text-red-400 ml-1 true">*</span></label> <textarea required="" style="width : 500px"
class="focus:outline-none focus:ring-2 focus:ring-green-900 focus:border-transparent block appearance-none p-3 max-w-full mb-1 text-base leading-normal bg-white text-gray-800 border-none ring-1 ring-gray-300 rounded"
placeholder="Masukan Alamat Anda"></textarea></div>
</div>
<div class="px-0 py-0"><img src="https://setunggal.dripform.id/fe50be48-0baa-4384-ae9e-93034f4b0e37.jpg" class="w-full" alt=""></div>
<div class="px-6 py-3">
<div class="mb-3"><label class="block text-md font-semibold text-gray-700 mb-3 flex" for="">Pilih Produk <span class="true text-red-400 ml-1">*</span></label>
<div class="border-dashed border-2 px-3 py-2 text-center">Product belum ditambahkan</div>
</div>
</div>
<div class="px-6 py-3">
<div class="my-3">
<h2 id="summary-heading" class="text-lg font-medium text-gray-900">Rincian Transaksi</h2>
<div class="mx-auto mt-3">
<div role="list" class="text-sm font-medium text-gray-900 divide-y divide-gray-200"> </div>
</div>
<dl class="text-sm font-medium text-gray-900 space-y-6">
<div class="flex items-center pt-4 justify-between">
<dt class="text-gray-600">Subtotal</dt>
<dd>Rp.0</dd>
</div>
<div class="flex items-center justify-between border-t border-gray-200 pt-6" style="border-top : 1px solid #e0e0e0">
<dt class="text-base">Total</dt>
<dd class="text-base">Rp.0</dd>
</div>
</dl>
</div>
</div>
</form>Text Content
PROMO PAKET AQIQAH TERBATAS! 00 Hari 23 Jam 59 Menit 55 Detik Nama Pemesan * Nomor WhataApp * + 345+1+1242+1246+1264+1268+1284+1340+1441+1473+1649+1664+1670+1671+1684+1758+1767+1784+1849+1868+1869+1876+1939+20+211+212+213+216+218+220+221+222+223+224+225+226+227+228+229+230+231+232+233+234+235+236+237+238+239+240+241+242+243+244+245+246+248+249+250+251+252+253+254+255+256+257+258+260+261+262+263+264+265+266+267+268+269+27+290+291+297+298+299+30+31+32+33+34+350+351+352+353+354+355+356+357+358+359+36+370+371+372+373+374+375+376+377+378+379+380+381+382+385+386+387+389+39+40+41+420+421+423+43+44+45+46+47+48+49+500+501+502+503+504+505+506+507+508+509+51+52+53+54+55+56+57+58+590+591+593+594+595+596+597+598+599+60+61+62+63+64+65+66+670+672+673+674+675+676+677+678+679+680+681+682+683+685+686+687+688+689+690+691+692+7+77+81+82+84+850+852+853+855+856+86+872+880+886+90+91+92+93+94+95+960+961+962+963+964+965+966+967+968+970+971+972+973+974+975+976+977+98+992+993+994+995+996+998 Alamat* Pilih Produk * Product belum ditambahkan RINCIAN TRANSAKSI Subtotal Rp.0 Total Rp.0