document.writeln('<script>function _fbcheck(f) { if (f.n.value=="") { alert("Please enter your Name"); f.n.focus(); return false; } if (f.t.value=="") { alert("Please enter your Contact No"); f.t.focus(); return false; } return true; }</script>');
document.writeln('<div id=fdiv><form method=post action="feedback.php" target=_irs onsubmit="return _fbcheck(this)"><input type=hidden name=token value="a685ace3a7dafd194e2e0f206b0e5f4e"><table style="font-size:1em">');
document.writeln('<tr><td><b>Name</b></td><td><input name=n size=30 value=""></td></tr>');
document.writeln('<tr><td><b>Email</b></td><td><input name=e size=30 value=""></td></tr>');
document.writeln('<tr><td><b>Contact No.</b></td><td><input name=t size=30 value=""></td></tr>');
document.writeln('<tr><td colspan=2><b>Message</b><br><textarea name=c rows=10 cols=50></textarea></td></tr>');
document.writeln('<tr><td colspan=2 align=center><input type=submit value="Send"></td></tr>');
document.writeln('</table></form></div><div style="display:none"><iframe width=1 height=1 name=_irs></iframe></div>');