 <script src="https://code.jquery.com/jquery-1.9.1.min.js"></script>
        <script src="https://apis.google.com/js/api.js"></script>
<div id="mauticform_wrapper_chatformpimolding" class="mauticform_wrapper">
    <form autocomplete="false" role="form" method="post" action="https://sas.emuaj.in/form/submit?formId=52" id="mauticform_chatformpimolding" data-mautic-form="chatformpimolding" enctype="multipart/form-data">
        <div class="mauticform-error" id="mauticform_chatformpimolding_error"></div>
        <div class="mauticform-message" id="mauticform_chatformpimolding_message"></div>
        <div class="mauticform-innerform">

            
          <div class="mauticform-page-wrapper mauticform-page-1" data-mautic-form-page="1">

            <div id="mauticform_chatformpimolding_f_name" data-validate="f_name" data-validation-type="text" class="mauticform-row mauticform-text mauticform-field-1 mauticform-required">
                <input id="mauticform_input_chatformpimolding_f_name" name="mauticform[f_name]" value="" placeholder="Name*" class="mauticform-input" type="text">
                <span class="mauticform-errormsg" style="display: none;">This is required</span>
            </div>

            <div id="mauticform_chatformpimolding_phone" data-validate="phone" data-validation-type="text" class="mauticform-row mauticform-text mauticform-field-2 mauticform-required">
                <input id="mauticform_input_chatformpimolding_phone" name="mauticform[phone]" value="" placeholder="Phone*" class="mauticform-input" type="text">
                <span class="mauticform-errormsg" style="display: none;">This is required</span>
            </div>

            <div id="mauticform_chatformpimolding_email" class="mauticform-row mauticform-text mauticform-field-3">
                <input id="mauticform_input_chatformpimolding_email" name="mauticform[email]" value="" placeholder="Email" class="mauticform-input" type="text">
                <span class="mauticform-errormsg" style="display: none;"></span>
            </div>

            <div id="mauticform_chatformpimolding_f_message" class="mauticform-row mauticform-text mauticform-field-4">
                <textarea id="mauticform_input_chatformpimolding_f_message" name="mauticform[f_message]" placeholder="Requirement" class="mauticform-textarea"></textarea>
                <span class="mauticform-errormsg" style="display: none;"></span>
            </div>

                <input id="mauticform_input_chatformpimolding_lead_source" name="mauticform[lead_source]" value="https://www.plastic-injectionmolding.com" class="mauticform-hidden" type="hidden">
            <div id="mauticform_chatformpimolding_submit" class="mauticform-row mauticform-button-wrapper mauticform-field-6">
                <button type="submit" name="mauticform[submit]" id="mauticform_input_chatformpimolding_submit" value="" style="color:white;background-color:#fe3108;hover: #0e1822;" class="mauticform-button">Yes, Let's Discuss Further!</button>
            </div>
            </div>
        </div>

        <input type="hidden" name="mauticform[formId]" id="mauticform_chatformpimolding_id" value="52">
        <input type="hidden" name="mauticform[return]" id="mauticform_chatformpimolding_return" value="">
        <input type="hidden" name="mauticform[formName]" id="mauticform_chatformpimolding_name" value="chatformpimolding">

        </form>
</div>