Patientenhemd „BARON“
Standardform

<p><div class="et_pb_section et_pb_section_4 et_section_regular"> <div id="modlog" class=" et_pb_row et_pb_row_4"> <div class="et_pb_column et_pb_column_4_4 et_pb_column_8 et_pb_css_mix_blend_mode_passthrough et-last-child"> <div class="et_pb_newsletter et_pb_login clearfix et_pb_module et_pb_bg_layout_light et_pb_text_align_left et_pb_login_1 et_pb_with_focus_border et_pb_with_border"> <div class="et_pb_newsletter_description"> <h2 class="et_pb_module_header">Status Mein dipasch</h2> <div class="et_pb_newsletter_description_content"><p>Hier sehen Sie Ihren aktuellen Status für <strong>Mein dipasch</strong>!</p></div> </div> <div class="et_pb_newsletter_form et_pb_login_form"> <form action="https://www.dipasch.de/wp-login.php" method="post"> <p> <label class="et_pb_contact_form_label" for="user_login_5adb5b921fd1c" style="display: none;">Benutzername</label> <input id="user_login_5adb5b921fd1c" placeholder="Benutzername" class="input" type="text" value="" name="log" /> </p> <p> <label class="et_pb_contact_form_label" for="user_pass_5adb5b921fd1c" style="display: none;">Passwort</label> <input id="user_pass_5adb5b921fd1c" placeholder="Passwort" class="input" type="password" value="" name="pwd" /> </p> <p class="et_pb_forgot_password"><a href="https://www.dipasch.de/mein-konto/lost-password/">Passwort vergessen</a></p> <p> <button type="submit" class="et_pb_newsletter_button et_pb_button">Anmelden</button> </p> </form> </div> </div> </div> <!-- .et_pb_column --> </div> <!-- .et_pb_row --> </div> <!-- .et_pb_section --> </p>