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pay.yoco.com Open in urlscan Pro
2606:4700::6812:16eb  Public Scan

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URL: https://pay.yoco.com/HwH-GP-practice
Submission: On January 29 via api from ZA — Scanned from DE

Form analysis 1 forms found in the DOM

<form style="padding: 0px 16px;">
  <div class="css-0">
    <h2>Payment details</h2>
    <div class="css-tuf3ow"><label class="css-7wh3a0">
        <div class="css-h4b1om">
          <div class="css-1588yp3">Amount (ZAR)</div>
        </div><input type="text" inputmode="decimal" id="amount" placeholder="Enter payment amount" field="amount" value="" style="
  width: 100%;
  height: 40px;
  -webkit-appearance: none;
  -moz-appearance: none;
  appearance: none;
  ::-webkit-outer-spin-button,
  ::-webkit-inner-spin-button {
    -webkit-appearance: none;
  }
  min-width: 15rem;
  padding: 0.75rem;
  color: #222;
  background: #fff;
  border-radius: 3px;
  border: 1px solid
    #C3C8D1;
  font-size: 14px;
  font-family: Inter, sans-serif;
  outline: none;

  
  
  
  
">
      </label></div>
    <div class="css-tuf3ow"><label class="css-7wh3a0">
        <div class="css-h4b1om">
          <div class="css-1588yp3">Reference</div>
        </div><input id="reference" type="text" placeholder="Optional payment reference" class="css-1xgns4c" value="">
      </label></div>
  </div>
  <div class="css-0">
    <h2>Your information</h2>
    <div class="css-tuf3ow"><label class="css-7wh3a0">
        <div class="css-h4b1om">
          <div class="css-1588yp3">First name</div>
        </div><input id="firstName" type="text" placeholder="Enter your first name" class="css-1xgns4c" value="">
      </label></div>
    <div class="css-tuf3ow"><label class="css-7wh3a0">
        <div class="css-h4b1om">
          <div class="css-1588yp3">Last name</div>
        </div><input id="lastName" type="text" placeholder="Enter your last name" class="css-1xgns4c" value="">
      </label></div>
    <div class="css-tuf3ow"><label class="css-7wh3a0">
        <div class="css-h4b1om">
          <div class="css-1588yp3">Email address</div>
        </div><input id="email" type="email" placeholder="Enter email address" class="css-1xgns4c" value="">
      </label></div>
  </div>
  <div class="css-0">
    <div>
      <div spacing="xx_small" class="css-xxq7rl"></div>
    </div><button id="charge-card-button" type="primary" disabled="" color="primary" class="css-sqwghy">
      <div class="css-10l7cct"><span class="css-9ywbij">Pay</span></div>
      <div class="css-vx0xxf"><svg viewBox="0 0 100 100" preserveAspectRatio="xMidYMid" style="display: inline-block; border-radius: 50%; width: 2.5rem; height: 2.5rem; position: relative;">
          <circle cx="50" cy="50" r="32" stroke-width="3" stroke="#ABABAB" stroke-dasharray="50.26548245743669 50.26548245743669" fill="none" stroke-linecap="round" transform="rotate(51.0005 50 50)">
            <animateTransform attributeName="transform" type="rotate" repeatCount="indefinite" dur="1s" keyTimes="0;1" values="0 50 50;360 50 50"></animateTransform>
          </circle>
        </svg>
        <p>Processing</p>
      </div>
    </button>
  </div>
</form>

Text Content

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HEALTH WITH HEART FAMILY PRACTICE

paywell@healthwithheart.co.za+27116855021


PAYMENT DETAILS

Amount (ZAR)
Reference


YOUR INFORMATION

First name
Last name
Email address
Pay

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