<form action="" method="post">
 <label for="email">Email:</label>
 <input type="email" name="log" id="email" required />
 <label for="password">Password:</label>
 <input type="password" name="pwd" id="password" required />
 <!-- Add nonce field -->
 <input type="hidden" id="appointment_login_nonce" name="appointment_login_nonce" value="747d032d11" /><input type="hidden" name="_wp_http_referer" value="/login/amp/" /> <input type="submit" name="appointment_login" value="Login" />
 </form>