<?xml version="1.0" encoding="UTF-8"?> <!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd"> <html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en"> <head> <meta content="text/html; charset=UTF-8" http-equiv="content-type" /> <meta http-equiv="cache-control" content="max-age=0" /> <meta http-equiv="cache-control" content="no-cache" /> <meta http-equiv="expires" content="0" /> <meta http-equiv="expires" content="Tue, 01 Jan 1980 1:00:00 GMT" /> <meta http-equiv="pragma" content="no-cache" /> <title>Patient Portal Login Form</title> <style type="text/css"> body { padding: 40px; font-family: "Open Sans Condensed", sans-serif; } h1{ display: block; font-size: 1.5em; margin-top: 2.33em; margin-bottom: .33em; margin-left: 0; margin-right: 0; font-weight: bold; } #bg { position: fixed; left: 0; top: 0; width: 100%; height: 100%; background-size: cover; -webkit-filter: blur(5px); } form { position: relative; width: 250px; margin: 0 auto; background: rgba(130,130,130,.3); padding: 20px 22px; border: 1px solid; border-top-color: rgba(255,255,255,.4); border-left-color: rgba(255,255,255,.4); border-bottom-color: rgba(60,60,60,.4); border-right-color: rgba(60,60,60,.4); } form input, form button { width: 212px; border: 1px solid; border-bottom-color: rgba(255,255,255,.5); border-right-color: rgba(60,60,60,.35); border-top-color: rgba(60,60,60,.35); border-left-color: rgba(80,80,80,.45); background-color: rgba(0,0,0,.2); background-repeat: no-repeat; padding: 8px 24px 8px 10px; font: bold .875em/1.25em "Open Sans Condensed", sans-serif; letter-spacing: .075em; color: #fff; text-shadow: 0 1px 0 rgba(0,0,0,.1); margin-bottom: 19px; } form input:focus { background-color: rgba(0,0,0,.4); } form input.pass { background-image: url(data:image/png;base64,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); background-position: 223px 8px } ::-webkit-input-placeholder { color: #ccc; text-transform: uppercase; } ::-moz-placeholder { color: #ccc; text-transform: uppercase; } :-ms-input-placeholder { color: #ccc; text-transform: uppercase; } form button[type=submit] { width: 248px; margin-bottom: 0; color: #cbe6e7; letter-spacing: .05em; text-shadow: 0 1px 0 #133d3e; text-transform: uppercase; background: #225556; border-top-color: #9fb5b5; border-left-color: #608586; border-bottom-color: #1b4849; border-right-color: #1e4d4e; cursor: pointer; } .tab { margin-left: 220px; } </style> </head> <body> <p> <table style="width: 550px" border="0"> <tbody> <tr> <td align="center"> <img title="Doctor" alt="" src="boy-2027615.png"> </td> <td> <h1>Patient Portal Login</h1> <form method="post" action="./PatientPortal.jsp" name="pform" id="pform"> <input name="action" value="login" type="hidden"> <br> <label for="username" style="display:none;"> Username</label> <input id="username" placeholder="username" name="username" type="text" title="username"> <label for="password" style="display:none;"> Password:</label><input name="password" id="password" placeholder="password" class="pass" type="password" title="password"> <button type="submit" value="Enter" id="Submit" >Login to your account</button> </form> </td> </tr> </tbody> </table> </p> <p class="tab"><img title="Crystal PM Icon" alt="Company Logo" src="crystalico.png">powered by Crystal Practice Management</p> </body> </html>