serviceportal-va.phre.eu Open in urlscan Pro
194.34.243.5  Public Scan

Form analysis
1 forms found in the DOM

POST ./

<form method="post" action="./" id="ReportIssueForm" enctype="multipart/form-data">
  <div class="aspNetHidden">
    <input type="hidden" name="__EVENTTARGET" id="__EVENTTARGET" value="">
    <input type="hidden" name="__EVENTARGUMENT" id="__EVENTARGUMENT" value="">
    <input type="hidden" name="__VIEWSTATE" id="__VIEWSTATE"
      value="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">
  </div>
  <script type="text/javascript">
    //<![CDATA[
    var theForm = document.forms['ReportIssueForm'];
    if (!theForm) {
      theForm = document.ReportIssueForm;
    }

    function __doPostBack(eventTarget, eventArgument) {
      if (!theForm.onsubmit || (theForm.onsubmit() != false)) {
        theForm.__EVENTTARGET.value = eventTarget;
        theForm.__EVENTARGUMENT.value = eventArgument;
        theForm.submit();
      }
    }
    //]]>
  </script>
  <script src="js/jquery-3.2.1.min.js" type="text/javascript"></script>
  <script src="js/busy.js" type="text/javascript"></script>
  <script src="js/reportissue.js" type="text/javascript"></script>
  <div class="aspNetHidden">
    <input type="hidden" name="__VIEWSTATEGENERATOR" id="__VIEWSTATEGENERATOR" value="4024A3AA">
    <input type="hidden" name="__EVENTVALIDATION" id="__EVENTVALIDATION"
      value="qsNDfc3nzDG4fU2QOWWv5i7q6+GGhV4a0+V12KYpRyWR3cqyYSQSicS83QVz/9ChihPjjoE3jF5p//Rh5gKa1cxWOxAKWSp3o5FUg80pT9HKkwYl6nKLHYOU6Mf2gn+9rekTdJIpc+sq5XcbWHxyu69PFmDtLyPSKG+V6sTrr9vnnvlt3gg7AnlwMHe6HZLBZCoaJFSBfWTc/VHr0hLIYtG5C4ToByc3u3lhUL1Jjb6RVSjBIyRnCV+31sj+KiiZZCjr6l+iWQnlLrWTcKLMoU2D5HkwHIcrBY+TILFp3NYVogRR+jaGOmmL/cCnfmSdLxR+/O5PCY5GM2DKnPuio9EC/5Hcyugowh7tcGhNBJYf0M7cdZUTVrpn1/ZEEyUEDF4Ti3Z+X4O8Ktz6q8wi9g==">
  </div>
  <div class="outermost-container">
    <div class="geoman-header">
      <div class="geoman-header-content geoman-header-content-withmenu">
        <span class="geoman-header-text">Neue Meldung eintragen</span>
      </div>
    </div>
    <div class="geoman-content">
      <!-- Um ein Feld zu einem Pfichtfeld zu machen, am "geoman-form-item" div die Klasse "required" ergänzen -->
      <!-- Um ein Feld zu verstecken, am "geoman-form-item" div die Klasse "hidden" ergänzen -->
      <div class="geoman-form-item">
        <label for="Issue" class="editCaption">Meldungsart</label>
        <div class="editCtl editCtlWithCaption">
          <select name="TicketTypeName" id="TicketTypeName">
            <option selected="selected" value="Servicemeldung">Servicemeldung</option>
            <option value="Mangelmeldung">Mangelmeldung</option>
            <option value="Wasserschaden">Wasserschaden</option>
          </select>
        </div>
      </div>
      <div id="NameMappedIssueContainer" class="geoman-form-item hidden">
        <label for="Issue" class="editCaption">Meldung</label>
        <div class="editCtl editCtlWithCaption">
          <select id="NameMappedIssue"></select>
        </div>
      </div>
      <div id="IssueContainer" class="geoman-form-item required">
        <label for="Issue" class="editCaption">Meldung</label>
        <div class="editCtl editCtlWithCaption">
          <textarea name="Issue" rows="5" cols="50" id="Issue"></textarea>
        </div>
      </div>
      <div class="geoman-form-item hidden">
        <label for="IssueContext" class="editCaption">Raumnummer</label>
        <div class="editCtl editCtlWithCaption">
          <input name="IssueContext" type="text" id="IssueContext">
        </div>
      </div>
      <div class="geoman-form-item required">
        <label for="IssueDescription" class="editCaption">Beschreibung</label>
        <div class="editCtl editCtlWithCaption">
          <textarea name="IssueDescription" rows="5" cols="50" id="IssueDescription"></textarea>
        </div>
      </div>
      <div class="geoman-form-item required">
        <label for="Trade" class="editCaption">Mieteinheit oder Praxis</label>
        <div class="editCtl editCtlWithCaption">
          <select name="TradeName" id="TradeName">
            <option value="Mieteinheit">Mieteinheit</option>
            <option value="Praxis">Praxis</option>
          </select>
        </div>
      </div>
      <div class="geoman-form-item required">
        <label for="ReporterName" class="editCaption">Name Ansprechpartner + Telefonnummer</label>
        <div class="editCtl editCtlWithCaption">
          <input name="ReporterName" type="text" id="ReporterName">
        </div>
      </div>
      <div class="geoman-form-item required">
        <label for="ReporterAddress" class="editCaption">Objektanschrift</label>
        <div class="editCtl editCtlWithCaption">
          <input name="ReporterAddress" type="text" id="ReporterAddress">
        </div>
      </div>
      <div class="geoman-form-item email-to required">
        <label for="EmailTo" class="editCaption">Email</label>
        <div class="editCtl editCtlWithCaption">
          <input name="EmailTo" type="text" id="EmailTo" validation-pattern="^[A-Za-z0-9|ä|ü|ö|Ä|Ü|Ö|\-|\.|_]+@[A-Za-z0-9|ä|ü|ö|Ä|Ü|Ö|\-|\.|_]+\.[A-Za-z0-9]{2,20}$">
        </div>
      </div>
      <div id="ImageUploadContainer" class="geoman-form-item image-upload">
        <div class="opener editCaption">
          <span class="button"></span>
        </div><input name="ctl06" type="file" class="file-input hidden" accept="image/*">
        <div class="editCtl editCtlWithCaption content-container preview"></div>
      </div>
      <div class="geoman-form-item required">
        <label for="Solution" class="editCaption">Neun plus Neun</label>
        <div class="editCtl editCtlWithCaption">
          <input name="Solution" type="number" id="Solution" placeholder="Sie sind kein Computer?">
        </div>
      </div>
      <div class="geoman-form-item">
        <div class="editCtl editCtlWithCaption">
          <span id="ServiceResult" style="color:#FF3300;"></span>
        </div>
      </div>
    </div>
    <div id="toolbarcontainer" class="toolbarcontainer">
      <table class="TOOLBAR" style="border-collapse: collapse;" border="0" cellpadding="0" cellspacing="0">
        <tbody>
          <tr>
            <td class="CellButton tbcSaveLink">
              <div tabindex="60" class="CellDescription">
                <table>
                  <tbody>
                    <tr>
                      <td class="CellButtonImage"></td>
                      <td class="CellButtonText">
                        <a id="SendButton" href="#">Senden</a>
                      </td>
                    </tr>
                  </tbody>
                </table>
              </div>
            </td>
            <td class="CellButton tbcCancelLink">
              <div tabindex="61" class="CellDescription">
                <table>
                  <tbody>
                    <tr>
                      <td class="CellButtonImage"></td>
                      <td class="CellButtonText">
                        <a id="CancelButton" href="#">Abbrechen</a>
                      </td>
                    </tr>
                  </tbody>
                </table>
              </div>
            </td>
          </tr>
        </tbody>
      </table>
    </div>
  </div>
</form>

Text Content

Neue Meldung eintragen
Meldungsart
Servicemeldung Mangelmeldung Wasserschaden
Meldung

Meldung

Raumnummer

Beschreibung

Mieteinheit oder Praxis
Mieteinheit Praxis
Name Ansprechpartner + Telefonnummer

Objektanschrift

Email


Neun plus Neun



Senden

Abbrechen