document.writeln('<table width=\"100%\" border=\"0\" cellspacing=\"2\" cellpadding=\"1\">')
document.writeln('<form name=\"myform\" action=\"/plus/form.asp\" method=\"post\"> ')
document.writeln('<input type=\"hidden\" value=\"Save\" name=\"action\">')
document.writeln('<input type=\"hidden\" value=\"1\" name=\"id\">')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\">反馈内容：</td>')
document.writeln('  <td><textarea style=\"width:450px;height:100px\" rows=\"5\" name=\"KS_fknr\"></textarea><font color=\"red\"> * </font> <span style=\"margin-top:5px\">您需要反馈的信息</span>  </td>')
document.writeln('</tr>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\">您的姓名：</td>')
document.writeln('  <td><input type=\"text\" class=\"upfile\" style=\"width:200px\" name=\"KS_cpmc\" value=\"\"><font color=\"red\"> * </font> <span style=\"margin-top:5px\">真实姓名</span>  </td>')
document.writeln('</tr>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\">手机号码：</td>')
document.writeln('  <td><input type=\"text\" class=\"upfile\" style=\"width:200px\" name=\"KS_mblt\" value=\"\"><font color=\"red\"> * </font> <span style=\"margin-top:5px\">手机号码</span>  </td>')
document.writeln('</tr>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\">电子邮箱：</td>')
document.writeln('  <td><input type=\"text\" class=\"upfile\" style=\"width:200px\" name=\"KS_email\" value=\"\"><font color=\"red\"> * </font> <span style=\"margin-top:5px\">方便我们回复信息 如：zha@163.com （可不填）</span>  </td>')
document.writeln('</tr>')
document.writeln('<tr class=\"tdbg\"><td class=\"lefttdbg\" align=\"right\">验证码：</td><td><input name=\"Verifycode\" type=\"text\" name=\"textbox\" size=5><span style=\"color:#999\">请输入下图中的字符</span><br/><IMG style=\"cursor:pointer\" src=\"/plus/verifycode.asp\" onClick=\"this.src=\'/plus/verifycode.asp?n=\'+ Math.random();\" align=\"absmiddle\"></td></tr>')
document.writeln('<tr><td colspan=\"2\" class=\"subtdbg\" align=\"center\"><input type=\"submit\" value=\"确认提交\" name=\"submit1\"></td></tr>')
document.writeln('</form>')
document.writeln('</table>')
document.writeln('')