mrini.programari.cloud.onlineservice.io Open in urlscan Pro
35.180.237.2  Public Scan

Form analysis
1 forms found in the DOM

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<form method="post" id="form" target="hiddenFrame">
  <!--    <div class="top-info" id="top-info" tabindex="-1" style="width: 100%">-->
  <!---->
  <!--    </div>-->
  <div class="container-fluid" style="padding: 25px 20px">
    <div class="row mb-4">
      <div class="col-md-12">
        <a href="https://mrini.ro/"><img style="margin-right: 30px; width: 256px;" src="https://mrini.ro/wp-content/uploads/2021/06/anmcs_logo-1.webp"></a>
        <a href="https://mrini.ro/" class="btn  back-to-site focus_button"> <i class="fa fa-chevron-left" style="padding-right: 5px"></i>Inapoi  in site</a>
      </div>
    </div>
  </div>
  <div class="container-fluid" id="page1">
    <div class="row mb-4">
      <div class="form-group col-md-12 col-lg-12">
        <label for="doctor_id"><strong>1. Alege tipul programarii</strong></label>
        <br>
        <div class="d-flex" style="margin-top: 6px">
          <input name="appointment_type_id" type="hidden" id="appointment_type" value="1">
          <input name="service_id" id="service_id" type="hidden" value="">
          <input type="hidden" id="role" value="2">
          <div id="div-service" class="btn-group-toggle" data-toggle="buttons"></div>
        </div>
        <p id="descriere_serviciu" style="font-size: 12px; font-style: italic; color: dimgrey"></p>
        <br>
        <div class="eye-options">
        </div>
        <br>
        <div>
          <div class="dropdown bootstrap-select"><select class="selectpicker" id="clinic_id" name="clinic_id" tabindex="-98">
            </select><button type="button" class="btn dropdown-toggle btn-light bs-placeholder" data-toggle="dropdown" role="combobox" aria-owns="bs-select-1" aria-haspopup="listbox" aria-expanded="false" data-id="clinic_id" title="Alege">
              <div class="filter-option">
                <div class="filter-option-inner">
                  <div class="filter-option-inner-inner">Alege</div>
                </div>
              </div>
            </button>
            <div class="dropdown-menu ">
              <div class="inner show" role="listbox" id="bs-select-1" tabindex="-1">
                <ul class="dropdown-menu inner show" role="presentation"></ul>
              </div>
            </div>
          </div>
        </div>
        <br>
        <input type="hidden" id="doctor_id" name="doctor_id" value="">
      </div>
    </div>
    <div class="row mb-4">
      <div class="form-group col-md-6 col-lg-4 custom_mobile">
        <label for="date"><strong>2. Alege data</strong></label>
        <div class="d-flex hide_mobile">
          <div class="custom-control custom-radio">
          </div>
          <div class="custom-control custom-radio">
            <br>
          </div>
        </div>
        <div class="datepicker" name="date">
          <input type="hidden" id="datepicker" name="date1" value="">
          <div class="datepicker datepicker-inline">
            <div class="datepicker-days" style="">
              <table class="table-condensed">
                <thead>
                  <tr>
                    <th colspan="7" class="datepicker-title" style="display: none;"></th>
                  </tr>
                  <tr>
                    <th class="prev">«</th>
                    <th colspan="5" class="datepicker-switch">Ianuarie 2024</th>
                    <th class="next">»</th>
                  </tr>
                  <tr>
                    <th class="dow">Lu</th>
                    <th class="dow">Ma</th>
                    <th class="dow">Mi</th>
                    <th class="dow">Jo</th>
                    <th class="dow">Vi</th>
                    <th class="dow">Sâ</th>
                    <th class="dow">Du</th>
                  </tr>
                </thead>
                <tbody>
                  <tr>
                    <td class="old day disabled" data-date="1703462400000" data-content="Alege tipul programarii.">25</td>
                    <td class="old day disabled" data-date="1703548800000" data-content="Alege tipul programarii.">26</td>
                    <td class="old day disabled" data-date="1703635200000" data-content="Alege tipul programarii.">27</td>
                    <td class="old day disabled" data-date="1703721600000" data-content="Alege tipul programarii.">28</td>
                    <td class="old day disabled" data-date="1703808000000" data-content="Alege tipul programarii.">29</td>
                    <td class="old day disabled" data-date="1703894400000" data-content="Alege tipul programarii.">30</td>
                    <td class="old day disabled" data-date="1703980800000" data-content="Alege tipul programarii.">31</td>
                  </tr>
                  <tr>
                    <td class="day disabled" data-date="1704067200000" data-content="Alege tipul programarii.">1</td>
                    <td class="day disabled" data-date="1704153600000" data-content="Alege tipul programarii.">2</td>
                    <td class="day disabled" data-date="1704240000000" data-content="Alege tipul programarii.">3</td>
                    <td class="day disabled" data-date="1704326400000" data-content="Alege tipul programarii.">4</td>
                    <td class="day disabled" data-date="1704412800000" data-content="Alege tipul programarii.">5</td>
                    <td class="day disabled" data-date="1704499200000" data-content="Alege tipul programarii.">6</td>
                    <td class="day disabled" data-date="1704585600000" data-content="Alege tipul programarii.">7</td>
                  </tr>
                  <tr>
                    <td class="day disabled" data-date="1704672000000" data-content="Alege tipul programarii.">8</td>
                    <td class="day disabled" data-date="1704758400000" data-content="Alege tipul programarii.">9</td>
                    <td class="day disabled" data-date="1704844800000" data-content="Alege tipul programarii.">10</td>
                    <td class="day disabled" data-date="1704931200000" data-content="Alege tipul programarii.">11</td>
                    <td class="day disabled" data-date="1705017600000" data-content="Alege tipul programarii.">12</td>
                    <td class="day disabled" data-date="1705104000000" data-content="Alege tipul programarii.">13</td>
                    <td class="day disabled" data-date="1705190400000" data-content="Alege tipul programarii.">14</td>
                  </tr>
                  <tr>
                    <td class="day disabled" data-date="1705276800000" data-content="Alege tipul programarii.">15</td>
                    <td class="day disabled" data-date="1705363200000" data-content="Alege tipul programarii.">16</td>
                    <td class="day disabled" data-date="1705449600000" data-content="Alege tipul programarii.">17</td>
                    <td class="day disabled" data-date="1705536000000" data-content="Alege tipul programarii.">18</td>
                    <td class="day disabled" data-date="1705622400000" data-content="Alege tipul programarii.">19</td>
                    <td class="day disabled" data-date="1705708800000" data-content="Alege tipul programarii.">20</td>
                    <td class="day disabled" data-date="1705795200000" data-content="Alege tipul programarii.">21</td>
                  </tr>
                  <tr>
                    <td class="day disabled" data-date="1705881600000" data-content="Alege tipul programarii.">22</td>
                    <td class="day disabled" data-date="1705968000000" data-content="Alege tipul programarii.">23</td>
                    <td class="day disabled" data-date="1706054400000" data-content="Alege tipul programarii.">24</td>
                    <td class="day disabled" data-date="1706140800000" data-content="Alege tipul programarii.">25</td>
                    <td class="day disabled" data-date="1706227200000" data-content="Alege tipul programarii.">26</td>
                    <td class="day disabled" data-date="1706313600000" data-content="Alege tipul programarii.">27</td>
                    <td class="day disabled" data-date="1706400000000" data-content="Alege tipul programarii.">28</td>
                  </tr>
                  <tr>
                    <td class="day disabled" data-date="1706486400000" data-content="Alege tipul programarii.">29</td>
                    <td class="day disabled" data-date="1706572800000" data-content="Alege tipul programarii.">30</td>
                    <td class="day disabled" data-date="1706659200000" data-content="Alege tipul programarii.">31</td>
                    <td class="new day disabled" data-date="1706745600000" data-content="Alege tipul programarii.">1</td>
                    <td class="new day disabled" data-date="1706832000000" data-content="Alege tipul programarii.">2</td>
                    <td class="new day disabled" data-date="1706918400000" data-content="Alege tipul programarii.">3</td>
                    <td class="new day disabled" data-date="1707004800000" data-content="Alege tipul programarii.">4</td>
                  </tr>
                </tbody>
                <tfoot>
                  <tr>
                    <th colspan="7" class="today" style="display: none;">Astăzi</th>
                  </tr>
                  <tr>
                    <th colspan="7" class="clear" style="display: none;">Șterge</th>
                  </tr>
                </tfoot>
              </table>
            </div>
            <div class="datepicker-months" style="display: none;">
              <table class="table-condensed">
                <thead>
                  <tr>
                    <th colspan="7" class="datepicker-title" style="display: none;"></th>
                  </tr>
                  <tr>
                    <th class="prev">«</th>
                    <th colspan="5" class="datepicker-switch">2024</th>
                    <th class="next">»</th>
                  </tr>
                </thead>
                <tbody>
                  <tr>
                    <td colspan="7"><span class="month focused">Ian</span><span class="month">Feb</span><span class="month">Mar</span><span class="month">Apr</span><span class="month">Mai</span><span class="month">Iun</span><span
                        class="month">Iul</span><span class="month">Aug</span><span class="month">Sep</span><span class="month">Oct</span><span class="month">Nov</span><span class="month">Dec</span></td>
                  </tr>
                </tbody>
                <tfoot>
                  <tr>
                    <th colspan="7" class="today" style="display: none;">Astăzi</th>
                  </tr>
                  <tr>
                    <th colspan="7" class="clear" style="display: none;">Șterge</th>
                  </tr>
                </tfoot>
              </table>
            </div>
            <div class="datepicker-years" style="display: none;">
              <table class="table-condensed">
                <thead>
                  <tr>
                    <th colspan="7" class="datepicker-title" style="display: none;"></th>
                  </tr>
                  <tr>
                    <th class="prev">«</th>
                    <th colspan="5" class="datepicker-switch">2020-2029</th>
                    <th class="next">»</th>
                  </tr>
                </thead>
                <tbody>
                  <tr>
                    <td colspan="7"><span class="year old">2019</span><span class="year">2020</span><span class="year">2021</span><span class="year">2022</span><span class="year">2023</span><span class="year focused">2024</span><span
                        class="year">2025</span><span class="year">2026</span><span class="year">2027</span><span class="year">2028</span><span class="year">2029</span><span class="year new">2030</span></td>
                  </tr>
                </tbody>
                <tfoot>
                  <tr>
                    <th colspan="7" class="today" style="display: none;">Astăzi</th>
                  </tr>
                  <tr>
                    <th colspan="7" class="clear" style="display: none;">Șterge</th>
                  </tr>
                </tfoot>
              </table>
            </div>
            <div class="datepicker-decades" style="display: none;">
              <table class="table-condensed">
                <thead>
                  <tr>
                    <th colspan="7" class="datepicker-title" style="display: none;"></th>
                  </tr>
                  <tr>
                    <th class="prev">«</th>
                    <th colspan="5" class="datepicker-switch">2000-2090</th>
                    <th class="next">»</th>
                  </tr>
                </thead>
                <tbody>
                  <tr>
                    <td colspan="7"><span class="decade old">1990</span><span class="decade">2000</span><span class="decade">2010</span><span class="decade focused">2020</span><span class="decade">2030</span><span class="decade">2040</span><span
                        class="decade">2050</span><span class="decade">2060</span><span class="decade">2070</span><span class="decade">2080</span><span class="decade">2090</span><span class="decade new">2100</span></td>
                  </tr>
                </tbody>
                <tfoot>
                  <tr>
                    <th colspan="7" class="today" style="display: none;">Astăzi</th>
                  </tr>
                  <tr>
                    <th colspan="7" class="clear" style="display: none;">Șterge</th>
                  </tr>
                </tfoot>
              </table>
            </div>
            <div class="datepicker-centuries" style="display: none;">
              <table class="table-condensed">
                <thead>
                  <tr>
                    <th colspan="7" class="datepicker-title" style="display: none;"></th>
                  </tr>
                  <tr>
                    <th class="prev">«</th>
                    <th colspan="5" class="datepicker-switch">2000-2900</th>
                    <th class="next">»</th>
                  </tr>
                </thead>
                <tbody>
                  <tr>
                    <td colspan="7"><span class="century old">1900</span><span class="century focused">2000</span><span class="century">2100</span><span class="century">2200</span><span class="century">2300</span><span
                        class="century">2400</span><span class="century">2500</span><span class="century">2600</span><span class="century">2700</span><span class="century">2800</span><span class="century">2900</span><span
                        class="century new">3000</span></td>
                  </tr>
                </tbody>
                <tfoot>
                  <tr>
                    <th colspan="7" class="today" style="display: none;">Astăzi</th>
                  </tr>
                  <tr>
                    <th colspan="7" class="clear" style="display: none;">Șterge</th>
                  </tr>
                </tfoot>
              </table>
            </div>
          </div>
        </div>
      </div>
      <div class="form-group col-md-6 col-lg-4 custom_mobile">
        <label for="hour"><strong>3. Alege ora</strong></label>
        <input type="hidden" name="hour" id="hour" value="">
        <!--                <input type="hidden" name="doctor_id" id="doctor_id">-->
        <div class="d-flex hide_mobile">
          <div class="custom-control custom-radio">
          </div>
          <div class="custom-control custom-radio">
            <br>
          </div>
        </div>
        <!--                <select class="selectpicker" id="hour" name="hour">-->
        <!--                                      <option selected>Alege</option>-->
        <!--                </select>-->
        <div id="doctor_time" class="btn-group-toggle" data-toggle="buttons"></div>
      </div>
    </div>
    <div class="bottom-info row">
      <div id="tip_consultatie_info">
        <strong></strong>
      </div>
      <div id="doctor_info" class="col-md-4 col-sm-12"></div>
      <div id="data_info" class="col-md-4 col-sm-12"></div>
      <div id="price_info" align="center"></div>
      <input id="info_data" type="hidden" name="info_data">
      <div style="text-align: center" class="col-md-4 col-sm-12">
        <button type="button" id="button1" class="btn focus_button">Pasul urmator</button>
      </div>
    </div>
    <div style="width: 100%; margin-top: 10px; margin-bottom: 30px" align="center">
      <a class="contact_link" href="contact" style="text-align: center; width: 100%">Nu găsești dată/ora dorite?</a><br><br>
    </div>
  </div>
  <div class="container-fluid" id="page2" style="display: none">
    <h2>Date personale</h2>
    <div class="row mb-4">
      <div class="col-12">
        <div class="alert alert-danger" role="alert" style="display: none;">
          <strong>Programarea nu a putut fi salvata</strong> Va rugam reincercati!
        </div>
      </div>
      <div class="form-group col-md-3">
        <label for="surname">Prenume</label>
        <input type="text" class="form-control" id="surname" name="surname">
      </div>
      <div class="form-group col-md-3">
        <label for="name">Nume</label>
        <input type="text" class="form-control" id="name" name="name">
      </div>
      <div class="form-group col-md-6">
        <label for="email">Email</label>
        <input type="email" class="form-control" id="email" name="email">
      </div>
      <div class="form-group col-md-6">
        <label for="phone">Telefon</label>
        <input type="tel" class="form-control" id="phone" name="phone">
      </div>
      <div class="form-group col-md-6">
        <label for="birthday">Data nasterii (ZZ/LL/AAAA)</label>
        <input type="text" class=" form-control" id="birthday" name="birthday" data-inputmask="'alias': 'date'">
      </div>
      <div class="form-group col-12">
      </div>
      <div class="form-group col-md-7">
        <label for="gdpr" class="checkbox-container pull-left"> Sunt de acord cu <a href="https://mrini.ro/politica-privind-prelucrarea-datelor-cu-caracter-personal/" target="_blank"> Politica de confidentialitate</a>
          <input type="checkbox" id="gdpr" name="gdpr">
          <span class="checkmark"></span>
        </label>
      </div>
    </div>
    <div class="bottom-info row">
      <div id="doctor_info1" class="col-md-4 col-sm-12"></div>
      <div id="data_info1" class="col-md-4 col-sm-12"></div>
      <div class="col-md-4 col-sm-12" style="text-align: center">
        <div id="price_info1" align="center"></div>
        <button type="submit" id="button2" class="btn focus_button">SALVEAZA PROGRAMARE</button>
      </div>
    </div>
  </div>
  <div class="container-fluid" role="alert" id="page3" style="display: none">
    <div class="row mb-4" style="height: 350px">
      <div style="margin-top: 150px; margin-left: 100px" align="center">
        <center>
          <h1 style="color: darkseagreen" align="center"><strong>Programarea a fost înregistrată cu succes, ai confirmarea pe email.<br> Mulțumim pentru încredere!</strong></h1>
        </center>
      </div>
    </div>
    <div class="bottom-info">
      <div id="doctor_info2"></div>
      <div id="data_info2"></div>
      <div>
        <div id="price_info2" align="center"></div>
        <!--                <a type="button" href="https://www.clario.ro/" target="_self" class="btn btn-primary">Inapoi la site</a>-->
      </div>
    </div>
  </div>
</form>

Text Content

Inapoi in site
1. Alege tipul programarii








Alege


2. Alege data



«Ianuarie
2024»LuMaMiJoViSâDu25262728293031123456789101112131415161718192021222324252627282930311234AstăziȘterge

«2024»IanFebMarAprMaiIunIulAugSepOctNovDecAstăziȘterge

«2020-2029»201920202021202220232024202520262027202820292030AstăziȘterge

«2000-2090»199020002010202020302040205020602070208020902100AstăziȘterge

«2000-2900»190020002100220023002400250026002700280029003000AstăziȘterge

3. Alege ora



Pasul urmator
Nu găsești dată/ora dorite?




DATE PERSONALE

Programarea nu a putut fi salvata Va rugam reincercati!
Prenume
Nume
Email
Telefon
Data nasterii (ZZ/LL/AAAA)

Sunt de acord cu Politica de confidentialitate

SALVEAZA PROGRAMARE


PROGRAMAREA A FOST ÎNREGISTRATĂ CU SUCCES, AI CONFIRMAREA PE EMAIL.
MULȚUMIM PENTRU ÎNCREDERE!


 * 
 * Consultatia se va face in clinica si va fi tinuta de un medic oftalmolog
   Clinica Mrini.
 *