jpsagrisolution.com - UnknownSec 403

UnknownSec Bypass 403

: /var/www/zenithentcare/stmedicosoftware/ptpanel/ [ drwxrwxr-x ]
name : signup.php
 <?php include "top.php";?>


<script>

</script>

<div class="wthree_agile_admin_info">
    <!-- /w3_agileits_top_nav-->
    <!-- /nav-->
    <div class="w3_agileits_top_nav">
        <ul id="gn-menu" class="gn-menu-main">
            <!-- //nav_agile_w3l -->
            <li class="second logo admin">
                <h1><a href="#"><i class="fa fa-graduation-cap" aria-hidden="true"></i>ST-Medico 2.1 </a></h1>
            </li>
            <li class="second full-screen">
                <section class="full-top">
                    <!-- <button id="toggle"><i class="fa fa-arrows-alt" aria-hidden="true"></i></button> -->
                </section>
            </li>
        </ul>
        <!-- //nav -->
    </div>
    <div class="clearfix"></div>
    <!-- //w3_agileits_top_nav-->

    <!-- /inner_content-->
    <div class="inner_content">
        <!-- /inner_content_w3_agile_info-->
        <div class="inner_content_w3_agile_info">
            <div class="registration admin_agile">
                <div class="signin-form profile admin">
                    <h2>Register Here</h2>
                    <div class="login-form">
                        <p align="left">Name</p>
                        <input type="text" id="txtName" name="txtName" required="" autocomplete="off">
                        <p align="left" style="padding-bottom: 10px">Gender</p>
                        <select class="form-control1" id="txtGender" name="txtGender"
                            style="font-size: 14px; background-color: transparent">
                            <option>Male</option>
                            <option>Female</option>
                            <option>Other</option>
                        </select>
                        <p align="left">Age</p>
                        <table width="100%">
                            <tr>

                                <td width="30%">
                                    <input type="text" class="form-control1" id="txtAge" name="txtAge"
                                        onkeypress="return isNumberKey(event,this);" placeholder="Age"
                                        style="font-size: 14px; width: 100%;">
                                </td>
                                <td width="40%" align="right" style="padding-top: 10px;">

                                    <select class="form-control1" id="cmbYear" name="cmbYear"
                                        style="font-size: 14px; background-color: transparent">
                                        <option>Year</option>
                                        <option>Months</option>
                                        <option>Days</option>
                                    </select>
                                </td>
                            </tr>
                        </table>

                        <p align="left">Mobile No.</p>
                        <input type="text" id="txtMobileNo" name="txtMobileNo" required="" autocomplete="off">
                        <input type="submit" name="btnlogin" id="btnlogin" value="Submit">

                        <p><br /><a href="login.php"> Click here to login</a></p>
                    </div>
                </div>
            </div>
            <!-- //inner_content_w3_agile_info-->
        </div>
        <!-- //inner_content-->
    </div>
</div>>
<!-- banner -->