document.writeln('<form name=\"myform\" action=\"/plus/form.asp\" method=\"post\"> ')
document.writeln('<input type=\"hidden\" value=\"Save\" name=\"action\">')
document.writeln('<input type=\"hidden\" value=\"1\" name=\"id\">')
document.writeln('')
document.writeln('  <div class=\"xming\">姓名:<input type=\"text\" class=\"upfile\" style=\"width:150px\" name=\"KS_xingming\" value=\"\">  </div>')
document.writeln('')
document.writeln('')
document.writeln('  <div class=\"phone\">电话:<input type=\"text\" class=\"upfile\" style=\"width:150px\" name=\"KS_dianhua\" value=\"\">  </div>')
document.writeln('')
document.writeln('')
document.writeln('<div class=\"baoming\" align=\"center\"><input style=\"border:none; background:none; color:#fff; width:150px; height:30px; text-align:center\" type=\"submit\" value=\"申请上门服务\" name=\"submit1\"></div>')
document.writeln('</form>')
document.writeln('')
document.writeln('')