{"content":"<form class=\"row\" method=\"POST\" action=\"\/maitre-de-stage-universitaire-MSU\/cadeau-lms\" enctype=\"application\/x-www-form-urlencoded\" id=\"rPdsYTOjluEeXvJ\"><div class=\"container-input col-md-6 mt-3\"><input id=\"HpkulBFsDicgvbT\"    maxlength=\"255\"  required placeholder=\"Nom*\" type=\"text\" name=\"formContactGift[lastName]\" value=\"\" class=\"form-control\"><\/div><div class=\"container-input col-md-6 mt-3\"><input id=\"XOvOagTuxGGoiVk\"    maxlength=\"255\"  required placeholder=\"Pr\u00e9nom*\" type=\"text\" name=\"formContactGift[firstName]\" value=\"\" class=\"form-control\"><\/div><div class=\"container-input col-md-12 mt-3\"><input id=\"ijQnFNqbtBPZTup\"    required placeholder=\"Email*\" type=\"email\" name=\"formContactGift[email]\" value=\"\" class=\"form-control\"><\/div><div class=\"container-input col-md-6 mt-3\"><input id=\"AUcBjnjOOfhOk_x\"    required placeholder=\"T\u00e9l\u00e9phone*\" type=\"text\" name=\"formContactGift[tel]\" value=\"\" class=\"form-control\"><\/div><div class=\"container-input col-md-6 mt-3\"><input id=\"NddkRPdZLTfEAhQ\"  minlength=\"5\"    maxlength=\"5\"  required placeholder=\"Code postal*\" type=\"text\" name=\"formContactGift[cp]\" value=\"\" class=\"form-control\"><\/div><div class=\"container-input col-md-12 mt-3\"><select  id=\"trLcmDbKveLJIZb\"  data-live-search=\"true\"    placeholder=\"\"  required class=\" form-control selectpicker\" name=\"formContactGift[spe]\"><option     value=\"\"><\/option><option     value=\"11\">ANESTHESIE REANIMATION<\/option><option     value=\"13\">BIOLOGIE MEDICALE<\/option><option     value=\"16\">MEDECINE CARDIOVASCULAIRE<\/option><option     value=\"82\">CHIRURGIE VISCERALE ET DIGESTIVE<\/option><option     value=\"17\">DERMATOLOGIE ET VENEREOLOGIE<\/option><option     value=\"22\">ENDOCRINOLOGIE-DIABETOLOGIE-NUTRITION<\/option><option     value=\"19\">HEPATO-GASTRO-ENTEROLOGIE<\/option><option     value=\"54\">GERIATRIE<\/option><option     value=\"23\">GYNECOLOGIE MEDICALE<\/option><option     value=\"24\">GYNECOLOGIE OBSTETRIQUE<\/option><option     value=\"42\">CHIRURGIE ORALE<\/option><option     value=\"41\">RHUMATOLOGIE<\/option><option     value=\"40\">MEDECINE PHYSIQUE DE READAPTATION<\/option><option     value=\"20\">RADIOLOGIE ET IMAGERIE MEDICALE<\/option><option     value=\"37\">PSYCHIATRIE<\/option><option     value=\"36\">PNEUMOLOGIE<\/option><option     value=\"35\">PEDIATRIE<\/option><option     value=\"34\">OTO-RHINO-LARYNGOLOGIE ET CHIRURGIE CERVICO-FACIALE<\/option><option     value=\"31\">NEUROLOGIE<\/option><option     value=\"30\">NEPHROLOGIE<\/option><option     value=\"29\">MEDECINE ET SANTE AU TRAVAIL<\/option><option    selected value=\"00\">MEDECINE GENERALE<\/option><option     value=\"89\">MEDECINE NUCLEAIRE<\/option><option     value=\"70\">MEDECINE INTERNE ET IMMUNOLOGIE CLINIQUE<\/option><option     value=\"91\">CHIRURGIE THORACIQUE ET CARDIOVASCULAIRE<\/option><option     value=\"72\">SANTE PUBLIQUE<\/option><option     value=\"45\">CHIRURGIE VASCULAIRE<\/option><option     value=\"101\">ONCOLOGIE<\/option><option     value=\"33\">OPHTALMOLOGIE<\/option><option     value=\"99\">CHIRURGIE PLASTIQUE, RECONSTRUCTRICE ET ESTHETIQUE<\/option><option     value=\"81\">CHIRURGIE ORTHOPEDIQUE ET TRAUMATOLOGIQUE<\/option><option     value=\"102\">CHIRURGIE PEDIATRIQUE<\/option><option     value=\"103\">GENETIQUE MEDICALE<\/option><option     value=\"64\">ANATOMIE ET CYTOLOGIE PATHOLOGIQUES<\/option><option     value=\"74\">NEUROCHIRURGIE<\/option><option     value=\"84\">CHIRURGIE MAXILLO-FACIALE<\/option><option     value=\"94\">CANCEROLOGIE OPTION CHIRURGIE CANCEROLOGIQUE<\/option><option     value=\"93\">CANCEROLOGIE OPTION IMAGERIE EN CANCEROLOGIE<\/option><option     value=\"12\">DERMATOPATHOLOGIE<\/option><option     value=\"211\">GERONTOLOGIE\/GERIATRIE<\/option><option     value=\"43\">UROLOGIE<\/option><option     value=\"63\">ORTHOPEDIE DENTO-MAXILO-FACIALE<\/option><option     value=\"25\">MALADIES INFECTIEUSES ET TROPICALES<\/option><option     value=\"500\">MEDECINE INTENSIVE-REANIMATION<\/option><option     value=\"46\">MEDECINE VASCULAIRE<\/option><option     value=\"53\">MEDECINE LEGALE ET EXPERTISES MEDICALES<\/option><option     value=\"106\">MEDECINE D'URGENCE<\/option><option     value=\"66\">MEDECINE DU SPORT<\/option><option     value=\"229\">HEMATOLOGIE<\/option><option     value=\"233\">ALLERGOLOGIE<\/option><option     value=\"236\">ANDROLOGIE<\/option><option     value=\"237\">MEDECINE PENITENTIAIRE<\/option><\/select><\/div><div class=\"container-input col-md-12 mt-3\"><input id=\"zTaqOUHSYdJnHuv\"  minlength=\"11\"    maxlength=\"11\"   placeholder=\"Votre num\u00e9ro RPPS\" type=\"text\" name=\"formContactGift[Rpps]\" value=\"\" class=\"form-control\"><\/div><div class=\"container-input col-md-12 mt-5 text-center\"><input   name=\"formContactGift[submit]\" id=\"WWEmuGyPpSkJtPm\" type=\"submit\" value=\"valider\" class=\"btn btn-theme-cian-clear\"><\/div><\/form>"}