document.write('<table width=100% border=0 cellspacing=0 cellpadding=0>');
document.write('<form name=form134 method=post action=/func/wzdc.asp target="_blank">');
document.write('<tr>');
document.write('<td align=center><table width=98% border=0 cellspacing=0 cellpadding=0><tr><td>如果您患有男性生殖系统疾病，您会怎么解决？<br><input type=radio name=r134 value=1>私下里打听偏方、秘方，怕别人知道<br><input type=radio name=r134 value=2>隐瞒<br><input type=radio name=r134 value=3>去找医生<br><input type=radio name=r134 value=4>打声讯台<br><input type=radio name=r134 value=5>告诉家人，帮忙解决<br><input name=dc_id  type=hidden value=134><input name=dc_number  type=hidden value=5><input name=dc_type  type=hidden value=1></td></tr></table></td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td>');
document.write('<table width=100% border=0 cellspacing=0 cellpadding=0 height=25><tr><td width=50% align=center><input name=imageField type=image src=/func/images/dc_tj.gif width=40 height=18 border=0></td><td width=50% align=center><a href=/func/ck_zldc.asp?dc_id=134 target="_blank"><img src=/func/images/dc_ck.gif width=60 height=18 border=0></a></td></tr></table>');
document.write('</td>');
document.write('</tr>');
document.write('</form>');
document.write('</table>');