struct
addresscatlist none
bodycontent <a name="par1"></a> <h1>Registrieren (Internet)</h1> <form action="/index.cfm?content=pwillereg&amp;spr=de&amp;debug=1&amp;lv=1" name="contactform" method="post" style="margin-top: 20px;" onsubmit="return checkOkOnSubmit('contactform');"> <input type="hidden" name="formname" value="contactform" /> <input type="hidden" name="contact_action" value="act_contact" /> <input type="hidden" name="acatlist" value="1000" /> <input type="hidden" name="paragraph" value="1" /> <input type="hidden" name="checktype" value="1" /> <div id="contactform"> <input type="hidden" name="adr_format" value="online" /> <div class="frow"> <div class="add_title">Name </div> <div class="input"><input class="inputFeld" style="" type="text" name="adr_name" title="Name" value="Name" maxlength="80" /></div> </div> <div class="frow"> <div class="add_title">Vorname </div> <div class="input"><input class="inputFeld" style="" type="text" name="adr_firstname" title="Vorname" value="Vorname" maxlength="40" /></div> </div> <div class="frow"> <div class="add_title">Geb. Datum </div> <div class="input"><input class="inputFeld" style="" type="text" name="adr_dateofbirth" title="Geb. Datum" value="" maxlength="10" /></div> </div> <div class="frow"> <div class="add_title">Versicherungs-Nr./AHV-Nr.&nbsp;<a id="help_dsp_nummer" class="help_box_file" target="_blank" href="/index.cfm?action=act_getfile&amp;doc_id=100001&amp;spr=de&amp;debug=1&amp;lv=1">&nbsp;</a></div> <div class="input"><input class="inputFeld" style="" type="text" name="adr_description1" title="Versicherungs-Nr./AHV-Nr." value="" maxlength="100" /></div> </div> <div class="frow"> <div class="add_title">Heimatort </div> <div class="input"><input class="inputFeld" style="" type="text" name="adr_description2" title="Heimatort" value="" maxlength="100" /></div> </div> <div class="frow"> <div class="add_title">Strasse, Nr. </div> <div class="input"><input class="inputFeld" style="" type="text" name="adr_street1" title="Strasse, Nr." value="" maxlength="80" /></div> </div> <div class="frow"> <div class="add_title">PLZ / Ort </div> <div class="input"> <input class="inputFeldzip" style="" type="text" name="adr_zip" value="5210" title="PLZ" maxlength="10" /> <input class="inputFeldcity" style="" type="text" name="adr_city" value="Windisch" title="Ort" maxlength="40" /> </div> </div> <div class="frow"> <div class="add_title">E-Mail Privat </div> <div class="input"><input class="inputFeld" style="" type="text" name="adr_emailhome" title="E-Mail Privat" value="" maxlength="80" /></div> </div> <div class="frow"> <div class="add_title">Passwort </div> <div class="input"><input class="inputFeld" style="" type="password" name="apwd_password" title="Passwort" value="" maxlength="80" /></div> </div> <div class="frow" style="height: 50px;"> <div class="add_title">Sicherheitsprüfung&nbsp;<a class="help_box" id="help_dsp_spamcheck" href="javascript:">&nbsp;</a></div> <div class="input"> <input type="hidden" name="checknumber" value="2" /> <span> <select name="spamcheck" size="1" title="Spam-Check" class="inputFeldspam"> <option value="">-</option> <option value="1">1</option> <option value="2">2</option> <option value="3">3</option> <option value="4">4</option> <option value="5">5</option> <option value="6">6</option> <option value="7">7</option> <option value="8">8</option> <option value="9">9</option> <option value="10">10</option> </select> W&auml;hlen Sie die folgende Zahl aus: <span class="spamnumber">zwei</span> &nbsp; </span> </div> </div> <div class="frow"> <div class="add_title"><input type="submit" name="submitter" value="Senden" class="butttonformat" /></div> <div class="input"></div> </div> </div> </form> <div id="warnings">Fehlermeldung</div> <br style="clear:both;" /><br><br>Nach dem Absenden erhalten Sie umgehend zwei E-Mails. Im ersten E-Mail<br>sehen Sie Ihre Zugangsdaten. Mit dem zweiten E-Mail schalten Sie Ihr<br>Benutzerkonto frei.<br>&nbsp;<br /><br /><a href="/index.cfm?content=20&amp;&amp;spr=de&amp;debug=1&amp;lv=1" class="linkformat">zurück zur &Uuml;bersicht</a>
lastaddressform
struct
adr_city Windisch
adr_emailoffice error.urban.obrist@3way.ch,nicole.stallone@3way.ch
adr_firstname Vorname
adr_name Name
adr_sex 1
adr_zip 5210
lasturl https://www.patientenwille.ch?&content=pwillereg&debug=1&lv=1
login
struct
ADR_CITY [empty string]
ADR_CUSTOMERADRNR [empty string]
ADR_CUSTOMERNR [empty string]
ADR_DATEOFBIRTH [empty string]
ADR_DESCRIPTION1 [empty string]
ADR_DESCRIPTION2 [empty string]
ADR_EMAILOFFICE [empty string]
ADR_FIRSTNAME [empty string]
ADR_ID [empty string]
ADR_KEY [empty string]
ADR_LANG [empty string]
ADR_NAME [empty string]
ADR_STREET1 [empty string]
ADR_TYPE [empty string]
ADR_ZIP [empty string]
APWD_ERPLOGIN [empty string]
APWD_ERPPASSWORD [empty string]
APWD_LOGIN [empty string]
APWD_PASSWORD [empty string]
addresscatlist none
creditlimit [empty string]
customersortiment [empty string]
discount 0
discountfactor 1
loginok 0
mobile 0
naviaccesslist suggest,sitemap,shop,search,rss,pwilleshow,pwilleregonoff,pwillereg,print,pdf,newsletter,mobile,login,impressum,home,format,favourite,contact,b60,b50,b40,b30,b20,b10,60,50,40,35,30,20
pazalastcontent [empty string]
pazalastmoduleurlparam [empty string]
pazalasturl [empty string]
today getdate()

Registrieren (Internet)

Name
Vorname
Geb. Datum
Versicherungs-Nr./AHV-Nr.  
Heimatort
Strasse, Nr.
PLZ / Ort
E-Mail Privat
Passwort
Sicherheitsprüfung  
Wählen Sie die folgende Zahl aus: zwei  
Fehlermeldung



Nach dem Absenden erhalten Sie umgehend zwei E-Mails. Im ersten E-Mail
sehen Sie Ihre Zugangsdaten. Mit dem zweiten E-Mail schalten Sie Ihr
Benutzerkonto frei.
 

zurück zur Übersicht
struct
addresscatlist none
bodycontent <a name="par1"></a> <h1>Registrieren (Internet)</h1> <form action="/index.cfm?content=pwillereg&amp;spr=de&amp;debug=1&amp;lv=1" name="contactform" method="post" style="margin-top: 20px;" onsubmit="return checkOkOnSubmit('contactform');"> <input type="hidden" name="formname" value="contactform" /> <input type="hidden" name="contact_action" value="act_contact" /> <input type="hidden" name="acatlist" value="1000" /> <input type="hidden" name="paragraph" value="1" /> <input type="hidden" name="checktype" value="1" /> <div id="contactform"> <input type="hidden" name="adr_format" value="online" /> <div class="frow"> <div class="add_title">Name </div> <div class="input"><input class="inputFeld" style="" type="text" name="adr_name" title="Name" value="Name" maxlength="80" /></div> </div> <div class="frow"> <div class="add_title">Vorname </div> <div class="input"><input class="inputFeld" style="" type="text" name="adr_firstname" title="Vorname" value="Vorname" maxlength="40" /></div> </div> <div class="frow"> <div class="add_title">Geb. Datum </div> <div class="input"><input class="inputFeld" style="" type="text" name="adr_dateofbirth" title="Geb. Datum" value="" maxlength="10" /></div> </div> <div class="frow"> <div class="add_title">Versicherungs-Nr./AHV-Nr.&nbsp;<a id="help_dsp_nummer" class="help_box_file" target="_blank" href="/index.cfm?action=act_getfile&amp;doc_id=100001&amp;spr=de&amp;debug=1&amp;lv=1">&nbsp;</a></div> <div class="input"><input class="inputFeld" style="" type="text" name="adr_description1" title="Versicherungs-Nr./AHV-Nr." value="" maxlength="100" /></div> </div> <div class="frow"> <div class="add_title">Heimatort </div> <div class="input"><input class="inputFeld" style="" type="text" name="adr_description2" title="Heimatort" value="" maxlength="100" /></div> </div> <div class="frow"> <div class="add_title">Strasse, Nr. </div> <div class="input"><input class="inputFeld" style="" type="text" name="adr_street1" title="Strasse, Nr." value="" maxlength="80" /></div> </div> <div class="frow"> <div class="add_title">PLZ / Ort </div> <div class="input"> <input class="inputFeldzip" style="" type="text" name="adr_zip" value="5210" title="PLZ" maxlength="10" /> <input class="inputFeldcity" style="" type="text" name="adr_city" value="Windisch" title="Ort" maxlength="40" /> </div> </div> <div class="frow"> <div class="add_title">E-Mail Privat </div> <div class="input"><input class="inputFeld" style="" type="text" name="adr_emailhome" title="E-Mail Privat" value="" maxlength="80" /></div> </div> <div class="frow"> <div class="add_title">Passwort </div> <div class="input"><input class="inputFeld" style="" type="password" name="apwd_password" title="Passwort" value="" maxlength="80" /></div> </div> <div class="frow" style="height: 50px;"> <div class="add_title">Sicherheitsprüfung&nbsp;<a class="help_box" id="help_dsp_spamcheck" href="javascript:">&nbsp;</a></div> <div class="input"> <input type="hidden" name="checknumber" value="2" /> <span> <select name="spamcheck" size="1" title="Spam-Check" class="inputFeldspam"> <option value="">-</option> <option value="1">1</option> <option value="2">2</option> <option value="3">3</option> <option value="4">4</option> <option value="5">5</option> <option value="6">6</option> <option value="7">7</option> <option value="8">8</option> <option value="9">9</option> <option value="10">10</option> </select> W&auml;hlen Sie die folgende Zahl aus: <span class="spamnumber">zwei</span> &nbsp; </span> </div> </div> <div class="frow"> <div class="add_title"><input type="submit" name="submitter" value="Senden" class="butttonformat" /></div> <div class="input"></div> </div> </div> </form> <div id="warnings">Fehlermeldung</div> <br style="clear:both;" /><br><br>Nach dem Absenden erhalten Sie umgehend zwei E-Mails. Im ersten E-Mail<br>sehen Sie Ihre Zugangsdaten. Mit dem zweiten E-Mail schalten Sie Ihr<br>Benutzerkonto frei.<br>&nbsp;<br /><br /><a href="/index.cfm?content=20&amp;&amp;spr=de&amp;debug=1&amp;lv=1" class="linkformat">zurück zur &Uuml;bersicht</a>
lastaddressform
struct
adr_city Windisch
adr_emailoffice error.urban.obrist@3way.ch,nicole.stallone@3way.ch
adr_firstname Vorname
adr_name Name
adr_sex 1
adr_zip 5210
lasturl https://www.patientenwille.ch?&content=pwillereg&debug=1&lv=1
login
struct
ADR_CITY [empty string]
ADR_CUSTOMERADRNR [empty string]
ADR_CUSTOMERNR [empty string]
ADR_DATEOFBIRTH [empty string]
ADR_DESCRIPTION1 [empty string]
ADR_DESCRIPTION2 [empty string]
ADR_EMAILOFFICE [empty string]
ADR_FIRSTNAME [empty string]
ADR_ID [empty string]
ADR_KEY [empty string]
ADR_LANG [empty string]
ADR_NAME [empty string]
ADR_STREET1 [empty string]
ADR_TYPE [empty string]
ADR_ZIP [empty string]
APWD_ERPLOGIN [empty string]
APWD_ERPPASSWORD [empty string]
APWD_LOGIN [empty string]
APWD_PASSWORD [empty string]
addresscatlist none
creditlimit [empty string]
customersortiment [empty string]
discount 0
discountfactor 1
loginok 0
mobile 0
naviaccesslist suggest,sitemap,shop,search,rss,pwilleshow,pwilleregonoff,pwillereg,print,pdf,newsletter,mobile,login,impressum,home,format,favourite,contact,b60,b50,b40,b30,b20,b10,60,50,40,35,30,20
pazalastcontent [empty string]
pazalastmoduleurlparam [empty string]
pazalasturl [empty string]
today getdate()
 


Loop time: 156 milliseconds
+ index.cfm
+ app_globals.cfm
+ common\config\app_locals.cfm
+ common\config\act_set_session.cfm
+ common\query\qry_sel_layout.cfm
+ common\layout\dsp_layout.cfm
+ common\layout\dsp_layoutbody1.cfm
+ common\layout\dsp_layoutbodytop.cfm
+ module\patientenwille\index.cfm
+ module\patientenwille\app_locals.cfm
+ module\login\index.cfm
+ module\login\app_locals.cfm
+ module\contact\index.cfm
+ module\contact\app_locals.cfm
+ module\contact\dsp_contactform.cfm