urlscan.io logo urlscan.io
SecurityTrails logo

wthjn.vital.io Open in urlscan Pro
2600:9000:214f:400:19:83fb:cb80:93a1  Public Scan

Back to summary
Submitted URL: https://vit.al/wthjn/p/2gLnmGRDgD?i
Effective URL: https://wthjn.vital.io/p/2gLnmGRDgD?i
Submission: On May 29 via manual from US — Scanned from DE

Form analysis 1 forms found in the DOM

<form>
  <div class="relative w-full space-y-4">
    <div class="w-full border-b"></div>
    <div class="mx-0 flex basis-full flex-col justify-end border-0 p-0">
      <div class="relative w-full space-y-1"><label class="flex w-fit items-baseline gap-1 p-0" id="8b9d764d-679e-40cd-b61f-5b5119f31fe9_label" for="8b9d764d-679e-40cd-b61f-5b5119f31fe9"><strong>Confirm Patient's Last Name</strong></label>
        <div class="relative flex w-full items-center rounded-md border-2 font-medium focus-within:border-kereru bg-white"><input
            class="block w-full grow border-0 bg-transparent px-2 pb-2 pt-1 text-inherit outline-0 placeholder:text-gray-400 disabled:cursor-not-allowed [&amp;[type=date]]:opacity-45 [&amp;[type=time]]:opacity-45"
            id="8b9d764d-679e-40cd-b61f-5b5119f31fe9" data-test-id="vital:response:input:lastname" value=""></div>
      </div>
    </div>
    <fieldset>
      <div class="relative w-full space-y-1">
        <legend class="flex items-baseline gap-1 p-0"><strong>Patient's Date of Birth</strong></legend>
        <div class="flex gap-2">
          <div class="mx-0 flex basis-full flex-col justify-end border-0 p-0">
            <div class="relative w-full space-y-1">
              <div class="relative w-full space-y-1" id="448a3c4f-d06e-4ac7-ae41-f16be18263fd"><label for="6d93d6c1-9424-49fd-bb12-55b838df0221-month">
                  <div class="inherit text-base font-normal">Month</div>
                </label>
                <div class="relative flex w-full items-center rounded-md border-2 font-medium focus-within:border-kereru bg-white"><input
                    class="block w-full grow border-0 bg-transparent px-2 pb-2 pt-1 text-inherit outline-0 placeholder:text-gray-400 disabled:cursor-not-allowed [&amp;[type=date]]:opacity-45 [&amp;[type=time]]:opacity-45"
                    id="6d93d6c1-9424-49fd-bb12-55b838df0221-month" maxlength="2" autocomplete="bday-month" data-test-id="vital:anatomy:memorable-date-input:month" inputmode="numeric" name="month" value=""></div>
              </div>
            </div>
          </div>
          <div class="mx-0 flex basis-full flex-col justify-end border-0 p-0">
            <div class="relative w-full space-y-1">
              <div class="relative w-full space-y-1" id="7bfdce84-f722-44e3-b64f-3fba5baad404"><label for="6d93d6c1-9424-49fd-bb12-55b838df0221-day">
                  <div class="inherit text-base font-normal">Day</div>
                </label>
                <div class="relative flex w-full items-center rounded-md border-2 font-medium focus-within:border-kereru bg-white"><input
                    class="block w-full grow border-0 bg-transparent px-2 pb-2 pt-1 text-inherit outline-0 placeholder:text-gray-400 disabled:cursor-not-allowed [&amp;[type=date]]:opacity-45 [&amp;[type=time]]:opacity-45"
                    id="6d93d6c1-9424-49fd-bb12-55b838df0221-day" maxlength="2" autocomplete="bday-day" data-test-id="vital:anatomy:memorable-date-input:day" inputmode="numeric" name="day" value=""></div>
              </div>
            </div>
          </div>
          <div class="mx-0 flex basis-full flex-col justify-end border-0 p-0">
            <div class="relative w-full space-y-1">
              <div class="relative w-full space-y-1" id="c7cb391f-a67e-4c06-a669-bb868eb3ffc5"><label for="6d93d6c1-9424-49fd-bb12-55b838df0221-year">
                  <div class="inherit text-base font-normal">Year</div>
                </label>
                <div class="relative flex w-full items-center rounded-md border-2 font-medium focus-within:border-kereru bg-white"><input
                    class="block w-full grow border-0 bg-transparent px-2 pb-2 pt-1 text-inherit outline-0 placeholder:text-gray-400 disabled:cursor-not-allowed [&amp;[type=date]]:opacity-45 [&amp;[type=time]]:opacity-45"
                    id="6d93d6c1-9424-49fd-bb12-55b838df0221-year" maxlength="4" autocomplete="bday-year" data-test-id="vital:anatomy:memorable-date-input:year" inputmode="numeric" name="year" minlength="4" value=""></div>
              </div>
            </div>
          </div>
        </div><span class="text-stone text-sm font-normal">For example 5 26 1983</span>
      </div>
    </fieldset><button
      class="items-center justify-center self-center gap-[0.5em] py-[0.5em] px-[1.25em] border-[0.125em] border-transparent rounded-full transition-all duration-200 no-underline flex w-full [&amp;>*:last-child]:mr-[-0.5em] cursor-not-allowed bg-disabled-background text-disabled-text"
      type="submit" data-test-id="button:get-started" data-dd-action-name="get started" disabled="">
      <div class="min-w-0 max-w-full text-center font-semibold">Get Started</div><svg viewBox="0 0 24 24" role="presentation" class="aspect-square h-[1.5em] shrink-0">
        <path d="M4,11V13H16L10.5,18.5L11.92,19.92L19.84,12L11.92,4.08L10.5,5.5L16,11H4Z" style="fill: currentcolor;"></path>
      </svg>
    </button>
  </div>
</form>

Text Content

Maps & Info


HI ANTHONY


WELCOME TO WEST TENNESSEE HEALTHCARE JACKSON NORTH HOSPITAL

Confirm the patient's last name and we'll keep you updated during this visit.

Confirm Patient's Last Name

Patient's Date of Birth
Month

Day

Year

For example 5 26 1983
Get Started

By clicking Get Started, you agree to our
Terms & Conditions, Privacy Policy, and are the patient, an authorized caregiver
for this patient, or have been invited by the patient.

English
Español
Tiếng Việt
Հայերեն
Af-Soomaali
한국어



THIS APP REQUIRES JAVASCRIPT.

To allow us to keep you updated about your visit, we need JavaScript to be
enabled.
Please turn on JavaScript in your browser's settings, and refresh the page.