client.shahvetclinic.com
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46.101.72.117
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URL:
https://client.shahvetclinic.com/
Submission: On July 21 via automatic, source certstream-suspicious — Scanned from GB
Submission: On July 21 via automatic, source certstream-suspicious — Scanned from GB
Form analysis 3 forms found in the DOM
POST login
<form action="login" method="post">
<div class="input-group mb-3">
<!-- <select name="code" required style="width:60px;">
</select>-->
<input style="width:40px;" type="text" readonly="" value="254">
<input type="tel" class="form-control" minlength="9" maxlength="9" required="" name="username" placeholder="7XXXXXXXX" style="border-radius:20px;border:1px solid #054314;">
<div class="input-group-append">
<div class="input-group-text">
<span class="fas fa-user"></span>
</div>
</div>
</div>
<div class="input-group mb-3">
<input type="email" class="form-control" minlength="3" required="" name="email" placeholder="me@example.com" style="border-radius:20px;border:1px solid #054314;">
<div class="input-group-append">
<div class="input-group-text">
<span class="fas fa-at"></span>
</div>
</div>
</div>
<!-- <div class="input-group mb-3">
<input type="password" class="form-control" required name="password" placeholder="Password">
<div class="input-group-append">
<div class="input-group-text">
<span class="fas fa-lock"></span>
</div>
</div>
</div>-->
<div class="row">
<div class="col-8">
<div class="icheck-primary">
<input type="checkbox" id="remember">
<label for="remember"> Remember Me </label>
</div>
</div>
<!-- /.col -->
<div class="col-4">
<button type="submit" class="btn btn-primary btn-sm btn-block">Sign In</button>
</div>
<!-- /.col -->
</div>
</form>POST appon
<form action="appon" method="post" onsubmit="document.getElementById('sub').disabled=true;">
<div class="row">
<div class="col-6"> Name:<input class="form-control" type="text" placeholder="Full Name" name="name" minlength="8" required="">
</div>
<div class="col-6"> Phone Number:<input class="form-control" type="text" placeholder="Phone Number" minlength="8" name="phone" required="">
</div>
<div class="col-6"> Email Address:<input class="form-control" type="text" placeholder="Email@me.com" minlength="8" name="email" required="">
</div>
<div class="col-6"> Pet Name(s):<input class="form-control" type="text" placeholder="Pet/Animal Name(s)" minlength="2" name="pname" required="">
</div>
<div class="col-6"> Date & time:<input class="form-control" type="datetime-local" placeholder="Name" name="date" required="">
</div>
<div class="col-6"> Service Booked: <select class="form-control select2 select2-hidden-accessible" required="" name="service[]" multiple="" data-placeholder="Select service" style="width: 100%;" data-select2-id="1" tabindex="-1"
aria-hidden="true">
<option>Defined below</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="2" style="width: 100%;"><span class="selection"><span class="select2-selection select2-selection--multiple" role="combobox"
aria-haspopup="true" aria-expanded="false" tabindex="-1" aria-disabled="false">
<ul class="select2-selection__rendered">
<li class="select2-search select2-search--inline"><input class="select2-search__field" type="search" tabindex="0" autocomplete="off" autocorrect="off" autocapitalize="none" spellcheck="false" role="searchbox" aria-autocomplete="list"
placeholder="Select service" style="width: 0px;"></li>
</ul>
</span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
</div>
<div class="col-6"> Comment:<textarea name="com" minlength="8" class="form-control" required=""></textarea>
</div>
<div class="col-6"> Urgency of service:<select class="form-control select2 select2-hidden-accessible" name="urgency" data-placeholder="Select urgency level" style="width: 100%;" data-select2-id="3" tabindex="-1" aria-hidden="true">
<option value="1" data-select2-id="5">Normal</option>
<option value="2">Medium</option>
<option value="3">Major</option>
<option value="4">Critical</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="4" style="width: 100%;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox"
aria-haspopup="true" aria-expanded="false" tabindex="0" aria-disabled="false" aria-labelledby="select2-urgency-h7-container"><span class="select2-selection__rendered" id="select2-urgency-h7-container" role="textbox" aria-readonly="true"
title="Normal">Normal</span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
</div>
<div class="col-sm-12 col-lg-6 col-md-6"> Enter Captcha code <div class="row">
<div class="col-lg-6 col-md-6 col-sm-6">
<input type="text" class="form-control" required="" id="submit" placeholder="Captcha code">
</div>
<div class="col-lg-3 col-md-3 col-sm-3">
<div id="image" selectable="False">7BEc</div>
</div>
<div class="col-lg-1 col-md-1 col-sm-1" onclick="generate()">
<i class="fas fa-sync"></i>
</div>
<div class="col-lg-2 col-md-2 col-sm-2">
<p id="key"></p>
</div>
</div>
<!--
<div class="col-lg-6 col-md-6 col-sm-6">
<input type="text" class="form-control" required id="submit"
placeholder="Captcha code" />
</div>-->
</div>
<div class="col-6"> <br><input class="btn btn-info" type="submit" name="sub" value="Book Now">
</div>
</div>
</form>POST apponrt
<form action="apponrt" method="post"> We value your feedback kindly rate our services & give us some feedback <div class="row">
<div class="col-sm-12 col-lg-6 col-md-6">
<span>Name</span>
<div class="input-group mb-3">
<div class="input-group-append">
<div class="input-group-text">
<span class="fas fa-user"></span>
</div>
</div>
<input class="form-control" type="text" placeholder="Full Name" name="name" required="">
</div>
</div>
<input type="hidden" name="wappo" value="1">
<div class="col-sm-12 col-lg-6 col-md-6">
<span>Phone Number</span>
<div class="input-group mb-3">
<div class="input-group-append">
<div class="input-group-text">
<span class="fas fa-headphones"></span>
</div>
</div><input class="form-control" type="text" placeholder="Phone Number" name="phone" required="">
</div>
</div>
<div class="col-sm-12 col-lg-6 col-md-6">
<span>Email Address</span>
<div class="input-group mb-3">
<div class="input-group-append">
<div class="input-group-text">
<span class="fas fa-envelope"></span>
</div>
</div><input class="form-control" type="email" placeholder="Email@me.com" name="email" required="">
</div>
</div>
<div class="col-sm-12 col-lg-6 col-md-6">
<div class="rate">
<span>Rate Us Now</span><br>
<input type="radio" id="star5" name="rate" value="5">
<label for="star5" title="text">5 stars</label>
<input type="radio" id="star4" name="rate" value="4">
<label for="star4" title="text">4 stars</label>
<input type="radio" id="star3" name="rate" value="3">
<label for="star3" title="text">3 stars</label>
<input type="radio" id="star2" name="rate" value="2">
<label for="star2" title="text">2 stars</label>
<input type="radio" id="star1" name="rate" value="1">
<label for="star1" title="text">1 star</label>
</div>
</div>
<div class="col-sm-12 col-lg-6 col-md-6">
<span>Select Feedback type</span>
<div class="input-group mb-3">
<div class="input-group-append">
<div class="input-group-text">
<span class="fas fa-list"></span>
</div>
</div>
<select class="form-control select2 select2-hidden-accessible" required="" name="question" data-placeholder="Select Question" data-select2-id="6" tabindex="-1" aria-hidden="true">
<option value="1" data-select2-id="8">How Will You Rate The Service Received?</option>
<option value="2">From A Scale Of 1(poor) To 10(excellent) How Will You Rate Our Service?</option>
<option value="3">What Other Products Should We Offer?</option>
<option value="4">How Can We Make Your Experience Even Better?</option>
<option value="5">From One (unhappy) To Ten (very Happy), How Would You Rate Your Overall Satisfaction With Us?</option>
<option value="6">Were Your Expectations Met, Unmet, Or Exceeded?</option>
<option value="7">On A Scale Of 1 (unlikely) To 10 (very Likely), How Likely Would You Be To Recommend Us To Friends Or Family?</option>
<option value="8">What Would You Like To See Changed?</option>
<option value="9">What Is Your Favorite Thing About Our Product/service?</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="7" style="width: auto;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox"
aria-haspopup="true" aria-expanded="false" tabindex="0" aria-disabled="false" aria-labelledby="select2-question-4r-container"><span class="select2-selection__rendered" id="select2-question-4r-container" role="textbox"
aria-readonly="true" title="How Will You Rate The Service Received?">How Will You Rate The Service Received?</span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span
class="dropdown-wrapper" aria-hidden="true"></span></span>
</div>
</div>
</div>
<div class="row">
<div class="col-sm-12 col-lg-6 col-md-6">
<span>Answer</span>
<div class="input-group mb-3">
<div class="input-group-append">
<div class="input-group-text">
<span class="fas fa-bookmark"></span>
</div>
</div>
<textarea name="answer" class="form-control" required=""></textarea>
</div>
</div>
<div class="col-sm-12 col-lg-6 col-md-6"> <br><input class="btn btn-info" style="background:#054314;color:white;" type="submit" name="sub" value="Rate us now">
</div>
</div>
</form>Text Content
Dr. K.A.Shah Veterinary Clinic * ELDORET CLIENT PORTAL * Login * Quick Appointments * Feedback & Reviews Client Sign in Enter phone number minus 0 Remember Me Sign In Powered by Biznapages Welcome to our online Client portal. We are dedicated to serve you online. Manage pet reminders Book Appointments Manage your Invoices Shop Online Plus more -------------------------------------------------------------------------------- Sale ON SALE Previous Next All Items Make Your Order Online Now! Name: Phone Number: Email Address: Pet Name(s): Date & time: Service Booked: Defined below * Comment: Urgency of service: Normal Medium Major Critical Normal Enter Captcha code 7BEc We value your feedback kindly rate our services & give us some feedback Name Phone Number Email Address Rate Us Now 5 stars 4 stars 3 stars 2 stars 1 star Select Feedback type How Will You Rate The Service Received? From A Scale Of 1(poor) To 10(excellent) How Will You Rate Our Service? What Other Products Should We Offer? How Can We Make Your Experience Even Better? From One (unhappy) To Ten (very Happy), How Would You Rate Your Overall Satisfaction With Us? Were Your Expectations Met, Unmet, Or Exceeded? On A Scale Of 1 (unlikely) To 10 (very Likely), How Likely Would You Be To Recommend Us To Friends Or Family? What Would You Like To See Changed? What Is Your Favorite Thing About Our Product/service? How Will You Rate The Service Received? Answer Powered by Biznapages