document.writeln('')
document.writeln('<iframe src=\"about:blank\" name=\"hidform12\" style=\"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=\"myform\" action=\"/plus/form/form.asp\" onSubmit=\"return(form_c());\"  target=\"hidform12\" method=\"post\"> ')
document.writeln('<table width=\"98%\" border=\"0\" cellspacing=\"2\" cellpadding=\"1\" height=\"493\">')
document.writeln('<input type=\"hidden\" value=\"Save\" name=\"action\"/>')
document.writeln('<input type=\"hidden\" value=\"12\" 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\" width=\"20%\">姓名：</td>')
document.writeln('  <td width=\"59%\"><input type=\"text\" maxlength=\"255\" class=\"upfile\" style=\"width:270px\" id=\"KS_name12\" name=\"KS_name12\" value=\"\"><span class=\"formstrck\" ')
document.writeln('id=\"姓名|%|KS_name12|%|1\" style=\"display:none\"></span><font color=\"red\"> * </font>  </td>')
document.writeln('</tr>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\" width=\"20%\">专业名称：</td>')
document.writeln('  <td width=\"59%\"><select class=\"upfile\" id=\"KS_zhuanye12\" style=\"width:300px\" name=\"KS_zhuanye12\"><option value=\"中医康复理疗师\">中医康复理疗师</option>')
document.writeln('<option value=\"中医食疗调理师\">中医食疗调理师</option><option value=\"中医健康管理师\">中医健康管理师</option><option value=\"中医预防保健调理师\">中医预防保')
document.writeln('健调理师</option><option value=\"心理咨询师\">心理咨询师</option><option value=\"AI健康管理师\">AI健康管理师</option><option value=\"AI健康讲师\">AI健康讲师')
document.writeln('</option><option value=\"AI营养师\">AI营养师</option></select><font color=\"red\"> * </font>  </td>')
document.writeln('</tr>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\" width=\"20%\">手机号码：</td>')
document.writeln('  <td width=\"59%\"><input type=\"text\" maxlength=\"255\" class=\"upfile\" style=\"width:300px\" id=\"KS_mob12\" name=\"KS_mob12\" value=\"\"><span class=\"formstrck\" ')
document.writeln('id=\"手机号码|%|KS_mob12|%|4\" style=\"display:none\"></span><font color=\"red\"> * </font>  </td>')
document.writeln('</tr>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\" width=\"20%\">电子邮箱：</td>')
document.writeln('  <td width=\"59%\"><input type=\"text\" maxlength=\"255\" class=\"upfile\" style=\"width:300px\" id=\"KS_email12\" name=\"KS_email12\" value=\"\"><span class=\"formstrck\" ')
document.writeln('id=\"电子邮箱|%|KS_email12|%|8\" style=\"display:none\"></span><font color=\"red\"> * </font>  </td>')
document.writeln('</tr>')
document.writeln(' <tr class=\"tdbg\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\" width=\"20%\">联系地址：</td>')
document.writeln('  <td width=\"59%\"><input type=\"text\" maxlength=\"255\" class=\"upfile\" style=\"width:300px\" id=\"KS_add12\" name=\"KS_add12\" value=\"\"><span class=\"formstrck\" ')
document.writeln('id=\"联系地址|%|KS_add12|%|1\" style=\"display:none\"></span><font color=\"red\"> * </font>  </td>')
document.writeln('</tr>')
document.writeln(' <tr class=\"tdbg\" style=\"display:none;\" width=\"20%\">')
document.writeln('  <td align=\"right\" class=\"lefttdbg\">颁发单位：</td>')
document.writeln('  <td width=\"59%\"><input type=\"text\" maxlength=\"255\" class=\"upfile\" style=\"width:300px\" id=\"KS_bfdw12\" name=\"KS_bfdw12\" value=\"重庆市卫生健康委员会国家职')
document.writeln('业技能鉴定所\"><span class=\"formstrck\" id=\"颁发单位|%|KS_bfdw12|%|1\" style=\"display:none\"></span><font color=\"red\"> * </font>  </td>')
document.writeln('</tr>')
document.writeln('<tr><td colspan=\"2\" class=\"subtdbg\" align=\"center\"><input type=\"submit\" value=\"只点一下等待7秒\" name=\"submit1\"></td></tr>')
document.writeln('</table>')
document.writeln('</form>')
document.writeln('')