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class="popup-box__form-item"> <input type="text" name="form[place_of_ issue]" class="popup-box__form-area" placeholder="Кем и когда выдан" max="200"> </div> <div class="popup-box__form-item"> <input type="text" data-name="diagnostic-name" name="form[id_namber]" max="30" class="popup-box__form-area" placeholder="Идентификационный номер"> </div> <div class="popup-box__form-item"> <input type="text" name="form[place_of_registration]" class="popup-box__form-area" placeholder="Место регистрации" max="60"> </div> <div class="popup-box__form-compliance"> <input id="compliance" type="checkbox" name="form[compliance]" required checked> <label for="compliance"></label> <span>Принимаю <a href="https://mrt.by/o-zashchite-personalnyh-dannyh">Условия</a> и даю согласие на обработку моих персональных данных</span> </div> <div class="popup-box__text popup-box__text_color_gray">С вами свяжется администратор, чтобы подтвердить запись.</div> <button class="btn _btn-green _full-width-mobile 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class="popup-box__title">Успешная отправка</strong> <button class="popup-box__close" data-popup-icon-close></button> <p class="popup-box__text">Спасибо, Ваш запрос принят!</p> <button class="btn _btn-green _full-width-mobile" type="button" data-popup-btn-close > Хорошо </button> </div> <div class="popup-box" data-popup-write-us data-popup-type="write-us"> <strong class="popup-box__title">Задайте ваш вопрос</strong> <button class="popup-box__close" data-popup-icon-close></button> <form class="popup-box__form form-diagnostic" data-validate> <div class="popup-box__form-item"> <input type="text" required name="form[name]" max="200" class="popup-box__form-area" placeholder="Ваше имя"> </div> <div class="popup-box__form-item"> <input type="email" required name="form[email]" pattern = "[a-z0-9._%+-]+@[a-z0-9.-]+\.[a-z]{2,4}$" class="popup-box__form-area" placeholder="E-mail"> </div> <div class="popup-box__form-item"> <textarea max="200" required rows="5" placeholder="Ваш вопрос" 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0.4h3.4c0.2 0 0.4-0.2 0.4-0.4v-8.3h3c0.2 0 0.4-0.2 0.4-0.4v-3.3c0-0.1 0-0.2-0.1-0.3s-0.1-0.1-0.2-0.1h-3.1v-1.9c0-0.9 0.2-1.4 1.4-1.4h1.7c0.2 0 0.4-0.2 0.4-0.4v-3.1c0.1-0.2-0.1-0.4-0.3-0.4z"/> </svg> </a> </li> <li class="social-list__item"> <a href="https://vk.com/medcenter.mrtby" class="social-list__link" target="_blank"> <?xml version="1.0" encoding="UTF-8"?> <svg enable-background="new 0 0 20 20" version="1.1" viewBox="0 0 20 20" xml:space="preserve" xmlns="http://www.w3.org/2000/svg"> <path d="m19.9 14.6c0-0.1 0-0.1-0.1-0.1-0.3-0.6-1-1.4-2-2.3-0.4-0.4-0.7-0.7-0.8-0.9-0.2-0.3-0.3-0.6-0.1-0.8 0.1-0.2 0.4-0.7 0.9-1.4 0.3-0.4 0.5-0.7 0.7-0.9 1.2-1.6 1.7-2.6 1.6-3.1l-0.2-0.1c0-0.1-0.1-0.1-0.3-0.2s-0.4-0.1-0.7 0h-3-0.2-0.1-0.1l-0.1 0.1c0 0.1-0.1 0.1-0.1 0.2-0.3 0.8-0.7 1.6-1.1 2.3-0.3 0.4-0.5 0.8-0.7 1.1-0.3 0.5-0.5 0.7-0.6 0.9l-0.4 0.4c-0.1 0.1-0.2 0.1-0.3 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0.1c0.1 0.1 0.3 0.2 0.5 0.2 0.2 0.1 0.4 0.1 0.6 0.1h2.7c0.3 0 0.5 0 0.6-0.1l0.3-0.3v-0.4c-0.1-0.3-0.1-0.3-0.1-0.4z"/> </svg> </a> </li> <li class="social-list__item"> <a href="https://www.instagram.com/medcenter.mrt.by" class="social-list__link" target="_blank"> <?xml version="1.0" encoding="UTF-8"?> <svg enable-background="new 0 0 20 20" version="1.1" viewBox="0 0 20 20" xml:space="preserve" xmlns="http://www.w3.org/2000/svg"> <path d="m14.5 0h-9c-3 0-5.5 2.5-5.5 5.5v9c0 3 2.5 5.5 5.5 5.5h9c3 0 5.5-2.5 5.5-5.5v-9c0-3-2.5-5.5-5.5-5.5zm3.7 14.5c0 2.1-1.7 3.7-3.7 3.7h-9c-2.1 0-3.7-1.7-3.7-3.7v-9c0-2.1 1.7-3.7 3.7-3.7h9c2.1 0 3.7 1.7 3.7 3.7v9z"/> <path d="m10 4.8c-2.8 0-5.2 2.3-5.2 5.2 0 2.8 2.3 5.2 5.2 5.2s5.2-2.3 5.2-5.2c0-2.8-2.4-5.2-5.2-5.2zm0 8.6c-1.9 0-3.4-1.5-3.4-3.4s1.5-3.4 3.4-3.4 3.4 1.5 3.4 3.4-1.5 3.4-3.4 3.4z"/> <path d="m15.4 3.3c-0.3 0-0.7 0.1-0.9 0.4-0.2 0.2-0.4 0.6-0.4 0.9s0.1 0.7 0.4 0.9c0.2 0.2 0.6 0.4 0.9 0.4s0.7-0.1 0.9-0.4c0.2-0.2 0.4-0.6 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