document.writeln('<iframe src=\"about:blank\" name=\"hidform1\" style=\"width:0px;height:0px;display:none\"></iframe>')
document.writeln('<script src=\"/ks_inc/common.js\"></script>')
document.writeln('<script src=\"/ks_inc/form_ck.js\"></script>')
document.writeln('<form name=\"myform1\" action=\"/plus/form/form.asp\" onSubmit=\"return(form_c(1));\"  target=\"hidform1\" method=\"post\"> ')
document.writeln('<table width=\"100%\" border=\"0\" cellspacing=\"2\" cellpadding=\"1\">')
document.writeln('<input type=\"hidden\" value=\"Save\" name=\"action\"/>')
document.writeln('<input type=\"hidden\" value=\"1\" name=\"id\"/>')
document.writeln('<input type=\"hidden\" value=\"0\" name=\"m\"/>')
document.writeln('<input type=\"hidden\" value=\"0\" name=\"d\"/>')
document.writeln('<input type=\"hidden\" value=\"{$ToUserName}\" id=\"tousername\" name=\"tousername\"/>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\"><font color=red><b>用途：</b></font></td>')
document.writeln('  <td><input type=\"radio\" id=\"KS_use4\" name=\"KS_use4\" value=\"胸牌\" checked>胸牌<input type=\"radio\" id=\"KS_use4\" name=\"KS_use4\" value=\"服务')
document.writeln('牌\">服务牌<input type=\"radio\" id=\"KS_use4\" name=\"KS_use4\" value=\"1寸白底\">1寸白底<input type=\"radio\" id=\"KS_use4\" name=\"KS_use4\" value=\"1寸')
document.writeln('蓝底\">1寸蓝底<input type=\"radio\" id=\"KS_use4\" name=\"KS_use4\" value=\"1寸红底\">1寸红底<input type=\"radio\" id=\"KS_use4\" name=\"KS_use4\" value=\"2')
document.writeln('寸白底\">2寸白底<input type=\"radio\" id=\"KS_use4\" name=\"KS_use4\" value=\"2寸蓝底\">2寸蓝底<input type=\"radio\" id=\"KS_use4\" name=\"KS_use4\" ')
document.writeln('value=\"2寸红底\">2寸红底<span class=\"formstrck1\" id=\"用途|%|KS_use4|%|6\" style=\"display:none\"></span><font color=\"red\"> * </font> <span ')
document.writeln('style=\"margin-top:5px\">服务牌还是胸牌，还是照片，看清楚</span>  </td>')
document.writeln('</tr>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\">科室：</td>')
document.writeln('  <td><input type=\"text\" maxlength=\"255\" class=\"upfile\" style=\"width:200px\" id=\"KS_dept\" name=\"KS_dept\" value=\"某某科\"><span ')
document.writeln('class=\"formstrck1\" id=\"科室|%|KS_dept|%|1\" style=\"display:none\"></span><font color=\"red\"> * </font> <span style=\"margin-top:5px\">填写您现在')
document.writeln('所在的科室</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\" maxlength=\"255\" class=\"upfile\" style=\"width:200px\" id=\"KS_uname\" name=\"KS_uname\" value=\"张某某\"><span ')
document.writeln('class=\"formstrck1\" id=\"您的姓名|%|KS_uname|%|1\" style=\"display:none\"></span><font color=\"red\"> * </font> <span style=\"margin-top:5px\">请如实')
document.writeln('填写您的姓名</span>  </td>')
document.writeln('</tr>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\">职称：</td>')
document.writeln('  <td><input type=\"text\" maxlength=\"8\" class=\"upfile\" style=\"width:200px\" id=\"KS_photoonline\" name=\"KS_photoonline\" value=\"主治医师/住院医')
document.writeln('师\"><span class=\"formstrck1\" id=\"职称|%|KS_photoonline|%|1\" style=\"display:none\"></span><font color=\"red\"> * </font> <span style=\"margin-')
document.writeln('top:5px\">注明您现在获得的最高职称，试岗或进修人员请参照第四点说明</span>  </td>')
document.writeln('</tr>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\">联系号码：</td>')
document.writeln('  <td><input type=\"text\" maxlength=\"255\" class=\"upfile\" style=\"width:200px\" id=\"KS_utel\" name=\"KS_utel\" value=\"13\"><span class=\"formstrck1\" ')
document.writeln('id=\"联系号码|%|KS_utel|%|1\" style=\"display:none\"></span><font color=\"red\"> * </font> <span style=\"margin-top:5px\">填写您的号码以便能正常联系')
document.writeln('</span>  </td>')
document.writeln('</tr>')
document.writeln('<tr class=\"tdbg\"><td class=\"lefttdbg\" align=\"right\"> 是否公开：</td><td><input name=\"Cipher\" value=\"1\" type=\"radio\" checked=\"checked\" ')
document.writeln('onclick=\"$(\'#PassWord\').hide();\">是(前台显示)<input name=\"Cipher\"  value=\"0\" type=\"radio\" ')
document.writeln('onclick=\"$(\'#PassWord\').show();$(\'input[name=PassWord]\').focus();\">否(查看要输入密码)<span id=\"PassWord\" style=\" display:none\"><BR/>输入密')
document.writeln('码:<input name=\"PassWord\"  type=\"password\" ></span></td></tr>')
document.writeln('<tr class=\"tdbg\"><td class=\"lefttdbg\" align=\"right\">验证码：</td><td><input name=\"Verifycode\" id=\"Verifycode\" type=\"text\" name=\"textbox\" ')
document.writeln('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\" ')
document.writeln('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=\"button\" name=\"Submit\" onclick=\"javascript:history.back(-1);\" value=\"返回上一')
document.writeln('页\">    <input type=\"submit\" value=\"确认提交\" name=\"submit1\" bgcolor=\"red\"></td></tr>')
document.writeln('</table>')
document.writeln('</form>')
document.writeln('')