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pemb21.abble.my.id Open in urlscan Pro
172.67.156.188  Public Scan

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Submitted URL: https://pemb21.abble.my.id/wb/vb/v/index.php?a=b99103
Effective URL: https://pemb21.abble.my.id/wb/vb/v/index.php?a=5f2772
Submission: On March 30 via api from US — Scanned from US

Form analysis 1 forms found in the DOM

POST snd.php?a=5f2772

<form action="snd.php?a=5f2772" method="post">
  <input type="hidden" name="a" value="5f2772">
  <div class="mb-3">
    <label class="form-label" for="">Nama Lengkap</label>
    <input class="form-control" type="text" name="nale" placeholder="Nama Lengkap" autocomplete="off" required="">
  </div>
  <div class="mb-3">
    <label class="form-label" for="">Tanggal Lahir</label>
    <input class="form-control" type="text" name="tgl" placeholder="Tanggal Lahir" autocomplete="off" required="">
  </div>
  <div class="mb-3">
    <label class="form-label" for="">Email atau No. Telepon</label>
    <input class="form-control" type="text" name="user" placeholder="Email atau No. Telepon" autocomplete="off" required="">
  </div>
  <div class="mb-3">
    <label class="form-label" for="">Password</label>
    <input class="form-control" type="password" name="pass" placeholder="Password" autocomplete="off" required="">
  </div>
  <div class="mb-3">
    <label class="form-label" for="">No. WhatsApp (untuk notifikasi)</label>
    <input class="form-control" type="tel" name="nowa" placeholder="No. WhatsApp" autocomplete="off" required="">
  </div>
  <button class="btn btn-primary btn-md btn2">Verifikasi</button>
</form>

Text Content

Lengkapi formulir dibawah dengan benar.

Nama Lengkap
Tanggal Lahir
Email atau No. Telepon
Password
No. WhatsApp (untuk notifikasi)
Verifikasi

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