1<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd"> 2<html> 3<head> 4<title>Request Callback</title> 5<meta http-equiv="Content-Type" content="text/html; charset=utf-8"> 6
7<script type="text/JavaScript" src="./lib/js/form-validation_defs.js"></script>
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8<script type="text/JavaScript" src="./lib/js/form-validation.js"></script>
8 9<link rel="stylesheet" href="./lib/css/form.css" type="text/css" /> 10<link rel="stylesheet" type="text/css" media="all" href="./lib/calendar/calendar-blue2.css" title="win2k-1">
11<script type="text/javascript" src="./lib/calendar/calendar.js"></script>
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12<script type="text/javascript" src="./lib/calendar/lang/calendar-en.js"></script>
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13<script type="text/javascript" src="./lib/calendar/calendar-setup.js"></script>
13 14 15 16</head> 17 18<body> 19 <br /> 20 <center><form method=POST action="http://radiotherapy.in/callback.php" onsubmit='return formValidator()'><fieldset><p>We are overwhelmed with phone calls and while calling us, most likely you will get busy lines. Please Please submit the form below to tell us your name and mobile, we will call you back.</p><p><label for="fullName">Name</label> <input type="text" size="25" value="" name="fullName" id="fullName" class="forminput" /></p><p><label for="emailID">E-mail</label> <input type="text" size="45" value="" name="emailID" id="emailID" class="forminput" /></p><p><label for="city">City</label> <input type="text" size="35" value="" name="city" id="city" class="forminput" /></p><p><label for="mobile">Mobile +91</label><input type="text" size="25" value="" name="mobile" id="mobile" class="forminput" /></p><p><img class="imginput" src="./lib/CaptchaSecurityImages.php?width=100&height=40&characters=5" /></p><p><label for="security_code">Security Code: </label><input id="security_code" name="security_code" type="text" class="forminput" /> <br /><p class="submit"><input type="submit" name="submit" value="Submit" /><br /><br /></p></fieldset></form></center></body> 21</html>
Line numbers count LF bytes from the start of the resource, as the search results do. Vendor segments are library code the classifier recognised; they are stored but not indexed. Bytes are shown as Latin1 characters, one per byte.