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document.write('<td align=center><table width=98% border=0 cellspacing=0 cellpadding=0><tr><td>你认为张国荣自杀的原因是：<br><input type=checkbox name=ck3321 value=1>个人感情受困<br><input type=checkbox name=ck3322 value=2>健康情况欠佳<br><input type=checkbox name=ck3323 value=3>事业近况不顺<br><input type=checkbox name=ck3324 value=4>遭人暗害<br><input type=checkbox name=ck3325 value=5>其他原因<br><input name=dc_id  type=hidden value=332><input name=dc_number  type=hidden value=5><input name=dc_type  type=hidden value=2></td></tr></table></td>');
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