parknet.parkmedicalcenters.com
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74.204.10.102
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URL:
https://parknet.parkmedicalcenters.com/apptsheet_DMC_form.cfm?referral_ID=480772&id=216379&l=189324329
Submission: On August 13 via manual from US — Scanned from DE
Submission: On August 13 via manual from US — Scanned from DE
Form analysis
1 forms found in the DOMPOST https://parknet.parkmedicalcenters.com/apptsheet_DMC_form.cfm
<form method="post" action="https://parknet.parkmedicalcenters.com/apptsheet_DMC_form.cfm">
<b>PASSWORD</b>: <input type="password" name="Password" size="20" maxlength="50" required="Yes" message="Password is Required."><br>
<input type="hidden" name="l" value="189324329"><input type="hidden" name="referral_ID" value="480772"><input type="hidden" name="ID" value="216379">
<input type="SUBMIT" name="myButton" value="LOGIN">
<br> For password assistance please call 248-356-5555 ext 118 or ext 126.
</form>
Text Content
PASSWORD: For password assistance please call 248-356-5555 ext 118 or ext 126.