document.writeln("<style type=\"text/css\">");
	document.writeln("<!--");
	document.writeln(".normalText { font-size: 9pt; color: #000000 }\r\n.normalText A { text-decoration: none; color: #000000 }\r\n.welcomeText { font-size: 9pt; font-weight: bold; text-align: center; }\r\n.buttonZone { font-size: 9pt; color: #000000 }\r\n.buttonZone input { font-size: 9pt; color: #000000 }");
	document.writeln("-->");
	document.writeln("</style>");



document.writeln("<TABLE border=\"0\" cellspacing=\"0\" cellpadding=\"5\" align=\"center\" width=\"92%\" height=\"30\" class=\"welcomeText\"><TR><TD>请填写您的订单信息</TD></TR></TABLE>");




function check_feedback_form(theform)
{

	if (theform.domain_1322.value.match(/^\s*$/))
	{
		alert("您没有填写 姓名,请填写完整的信息!");
		return false;
	}

	if (theform.domain_1323.value.match(/^\s*$/))
	{
		alert("您没有填写 E-Mail,请填写完整的信息!");
		return false;
	}

	if (theform.domain_4052.value.match(/^\s*$/))
	{
		alert("您没有填写 报告定单,请填写完整的信息!");
		return false;
	}

	if (theform.domain_4053.value.match(/^\s*$/))
	{
		alert("您没有填写 发货地址,请填写完整的信息!");
		return false;
	}

	if (theform.domain_4055.value.match(/^\s*$/))
	{
		alert("您没有填写 联系电话,请填写完整的信息!");
		return false;
	}

	var _feedback_form_submit = window.open("http://61.135.129.87/front/feedback_form/feedback_form_submit_wait.htm","_feedback_form_submit","toolbar=0,location=0,status=0,menubar=0,resizable=0,scrollbars=0,top=100,left=120,width=460,height=260");

	return true;
}

document.writeln("<TABLE border=\"0\" cellspacing=\"1\" cellpadding=\"5\" align=\"center\" width=\"92%\" bgcolor=\"#CCCCCC\" class=\"normalText\">");

document.writeln("  <form name=\"formX\" method=\"post\" action=\"http://61.135.129.87/front/feedback_form/feedback_form_submit.jsp\" target=\"_feedback_form_submit\" onsubmit=\"return check_feedback_form(this);\">");
document.writeln("  <input type=\"hidden\" name=\"service_user_id\" value=\"195\">");

document.writeln("  <TR >");

document.writeln("    <TD align=\"center\" bgcolor=\"#EFEFEF\" width=\"35%\">姓名</TD>");
document.writeln("    <TD bgcolor=\"#FFFFFF\" width=\"65%\">");

document.writeln("    <input type=\"text\" name=\"domain_1322\" size=\"32\">");

document.writeln("    </TD>");

document.writeln("  </TR>");

document.writeln("  <TR >");

document.writeln("    <TD align=\"center\" bgcolor=\"#EFEFEF\" width=\"35%\">E-Mail</TD>");
document.writeln("    <TD bgcolor=\"#FFFFFF\" width=\"65%\">");

document.writeln("    <input type=\"text\" name=\"domain_1323\" size=\"32\">");

document.writeln("    </TD>");

document.writeln("  </TR>");

document.writeln("  <TR >");

document.writeln("    <TD align=\"center\" bgcolor=\"#EFEFEF\" width=\"35%\">报告定单</TD>");
document.writeln("    <TD bgcolor=\"#FFFFFF\" width=\"65%\">");

document.writeln("    <div bgcolor=\"#FFFFFF\" style=\"padding-left: 0px; padding-right: 0px; padding-top: 4px; padding-bottom: 4px;\">请您填写报告名称</div>");

document.writeln("    <input type=\"text\" name=\"domain_4052\" size=\"28\">");

document.writeln("    </TD>");

document.writeln("  </TR>");

document.writeln("  <TR >");

document.writeln("    <TD align=\"center\" bgcolor=\"#EFEFEF\" width=\"35%\">发货地址</TD>");
document.writeln("    <TD bgcolor=\"#FFFFFF\" width=\"65%\">");

document.writeln("    <div bgcolor=\"#FFFFFF\" style=\"padding-left: 0px; padding-right: 0px; padding-top: 4px; padding-bottom: 4px;\">请您填写发货地址</div>");

document.writeln("    <input type=\"text\" name=\"domain_4053\" size=\"28\">");

document.writeln("    </TD>");

document.writeln("  </TR>");

document.writeln("  <TR >");

document.writeln("    <TD align=\"center\" bgcolor=\"#EFEFEF\" width=\"35%\">发票抬头</TD>");
document.writeln("    <TD bgcolor=\"#FFFFFF\" width=\"65%\">");

document.writeln("    <div bgcolor=\"#FFFFFF\" style=\"padding-left: 0px; padding-right: 0px; padding-top: 4px; padding-bottom: 4px;\">请您填写发票抬头</div>");

document.writeln("    <input type=\"text\" name=\"domain_4054\" size=\"28\">");

document.writeln("    </TD>");

document.writeln("  </TR>");

document.writeln("  <TR >");

document.writeln("    <TD align=\"center\" bgcolor=\"#EFEFEF\" width=\"35%\">联系电话</TD>");
document.writeln("    <TD bgcolor=\"#FFFFFF\" width=\"65%\">");

document.writeln("    <div bgcolor=\"#FFFFFF\" style=\"padding-left: 0px; padding-right: 0px; padding-top: 4px; padding-bottom: 4px;\">请填写你的电话</div>");

document.writeln("    <input type=\"text\" name=\"domain_4055\" size=\"28\">");

document.writeln("    </TD>");

document.writeln("  </TR>");


document.writeln("</TABLE>");

document.writeln("<TABLE align=\"center\" height=\"36\" class=\"buttonZone\">");
document.writeln("  <tr><td>");
document.writeln("    <input type=\"submit\" name=\"btok\" value=\" 提交 \">");
document.writeln("    <input type=\"reset\" name=\"btrst\" value=\" 重填 \">");
document.writeln("  </td></tr>");
document.writeln("  </form>");
document.writeln("</table>");