medical-claim-dev.teknovatus.com Open in urlscan Pro
103.129.152.129  Public Scan

Form analysis
1 forms found in the DOM

POST https://medical-claim-dev.teknovatus.com/login/proses_login

<form action="https://medical-claim-dev.teknovatus.com/login/proses_login" class="form-validate is-alter" autocomplete="off" method="post" novalidate="novalidate">
  <div class="form-group">
    <div class="form-label-group">
      <label class="form-label" for="default-01">Email</label>
    </div>
    <div class="form-control-wrap">
      <input autocomplete="email" type="email" class="form-control form-control-lg" required="" id="email-address" name="email" placeholder="Enter your email address">
    </div>
  </div>
  <div class="form-group">
    <div class="form-label-group">
      <label class="form-label" for="password">Passcode</label>
    </div>
    <div class="form-control-wrap">
      <a href="#" class="form-icon form-icon-right passcode-switch lg is-hidden" data-target="password">
                                        <em class="passcode-icon icon-show icon ni ni-eye"></em>
                                        <em class="passcode-icon icon-hide icon ni ni-eye-off"></em>
                                    </a>
      <input autocomplete="new-password" type="password" class="form-control form-control-lg" required="" id="password" name="password" placeholder="Enter your passcode">
    </div>
  </div>
  <div class="form-group">
    <button style="background-color: #1464b4; " class="btn btn-lg btn-primary btn-block">Sign in</button>
    <button style="background-color: #385a64;" id="btnForgotPass" class="btn btn-lg btn-secondary btn-block">Forgot Password</button>
  </div>
</form>

Text Content

SIGN-IN - SERVER DEVELOPMENT

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Passcode

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