www.randex.com.tr.ajanscodemo.com.tr Open in urlscan Pro
213.238.191.54  Public Scan

Form analysis
1 forms found in the DOM

POST system/appointment.php

<form id="form-wizard" action="system/appointment.php" method="POST">
  <div id="step-header" class="justify-content-between mb-4">
    <div class="container">
      <div class="row">
        <div class="stepper-wrapper">
          <div class="step-title step1 active">
            <div class="step-counter">1</div>
            <div class="step-name">Bilgi</div>
          </div>
          <div class="step-title step2">
            <div class="step-counter">2</div>
            <div class="step-name">Tarih</div>
          </div>
          <div class="step-title step3">
            <div class="step-counter">3</div>
            <div class="step-name">Hizmet</div>
          </div>
          <div class="step-title step4">
            <div class="step-counter">4</div>
            <div class="step-name">Not</div>
          </div>
          <div class="step-title step5">
            <div class="step-counter">5</div>
            <div class="step-name">Ödeme</div>
          </div>
        </div>
      </div>
    </div>
  </div>
  <!-- Step 1: Personal Information -->
  <div id="step-1" class="form-step">
    <div class="row">
      <div class="col-md-12">
        <span data-bs-toggle="modal" data-bs-target="#exampleModal" class="badge bg-warning" style="color:black;margin-bottom:15px">Eski Randevularım </span><br>
      </div>
      <div class="col-md-6">
        <div class="form-floating mb-3">
          <input type="text" class="form-control" id="name" name="name" placeholder="Name" required="">
          <label for="name" class="form-label">Adınız</label>
        </div>
      </div>
      <div class="col-md-6">
        <div class="form-floating mb-3">
          <input type="text" class="form-control" id="surname" name="surname" placeholder="Surname" required="">
          <label for="surname" class="form-label">Soyadınız</label>
        </div>
      </div>
      <div class="col-md-6">
        <div class="form-floating mb-3">
          <input type="email" class="form-control" id="email" name="email" placeholder="Email" required="">
          <label for="email" class="form-label">Email</label>
        </div>
      </div>
      <div class="col-md-6">
        <div class="form-floating mb-3">
          <input type="tel" class="form-control" id="phone" name="phone" placeholder="Phone" required="">
          <label for="phone" class="form-label">Telefon</label>
        </div>
      </div>
    </div>
  </div>
  <!-- Step 2: Date and Time -->
  <div id="step-2" class="form-step d-none">
    <div class="col-md-12">
      <div class="form-floating mb-3">
        <input type="text" class="form-control hasDatepicker" id="date" name="date" autocomplete="off" required="">
        <label for="date" class="form-label">Tarih</label>
      </div>
    </div>
    <div class="col-md-12">
      <div id="hourSelectionMessage" class="alert alert-danger d-none" role="alert"> Lütfen Bir Saat Seçin </div>
      <div id="time">
        <div class="btn-group col-lg-3 col-md-3 col-sm-3 col-3 mb-2" data-toggle="buttons">
          <label class="btn btn-sm btn-outline-time">
            <input type="radio" re="" name="saat" id="hour-2" value="12:00" autocomplete="off"> <span class="custom-margin">12:00</span>
          </label>
        </div>
      </div>
    </div>
  </div>
  <!-- Step 3: Service and Personnel Selection -->
  <div id="step-3" class="form-step d-none">
    <div class="form-floating mb-3">
      <select class="form-select" name="service" id="serviceSelect" onchange="getPrice(this.value)">
        <option value="">Hizmet Seçin</option>
        <option value="1">Test Servis | 1TL</option>
        <option value="2">Test Servis | 1TL</option>
      </select>
      <label for="serviceSelect" class="form-label">Servis</label>
    </div>
    <!-- Hidden input for price -->
    <input type="hidden" name="price" id="servicePrice" value="">
    <div class="form-floating mb-3">
      <select class="form-select" name="personel" id="personnelSelect" required="">
        <option value="">Çalışan Seçin</option>
      </select>
      <label for="personnelSelect" class="form-label">Çalışan</label>
    </div>
  </div>
  <!-- Step 4: Note -->
  <div id="step-4" class="form-step d-none">
    <div class="form-floating mb-3">
      <textarea class="form-control" name="note" id="noteTextarea" rows="3"></textarea>
      <label for="noteTextarea">Not (opsiyonel)</label>
    </div>
  </div>
  <!-- Step 5: Completion -->
  <div id="step-5" class="form-step d-none">
    <div class="form-floating mb-3">
      <select name="paymentMethod" class="form-select" id="paymentMethod">
        <option value="">Ödeme Yöntemi</option>
        <option value="credit_card">Kredi Kartı</option>
        <option value="havale">Havale</option>
        <option value="isyeri">İş Yerinde Ödeme</option>
      </select>
      <label for="serviceSelect" class="form-label">Ödeme Yöntemi</label>
    </div>
  </div>
  <!-- Previous and Next buttons -->
  <div class="text-center mt-4">
    <button id="prevBtn" type="button" class="btn btn-secondary d-none">Geri</button>
    <button id="nextBtn" type="button" class="btn btn-custom-primary">İleri</button>
    <button id="submitBtn" type="button" class="btn btn-edit d-none">Bitir</button>
  </div>
</form>

Text Content

1
Bilgi
2
Tarih
3
Hizmet
4
Not
5
Ödeme
Eski Randevularım

Adınız
Soyadınız
Email
Telefon
Tarih
Lütfen Bir Saat Seçin
12:00
Hizmet Seçin Test Servis | 1TL Test Servis | 1TL Servis
Çalışan Seçin Çalışan
Not (opsiyonel)
Ödeme Yöntemi Kredi Kartı Havale İş Yerinde Ödeme Ödeme Yöntemi
Geri İleri Bitir
Randevu Numaranız :
Kontrol Et
Kapat