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<label for="c_intentionIntro" class="e_title col-sm-2 control-label d_formItemTitle h5 color_normal p_intentionIntroTitle">
                                                姓名：
                    </label>
                    <div   id="iou88m3"   class="e_input p_FullName" data-ename="單行文本輸入框">
                        <input id="" name="item_22" data-type="1" data-subType="1"
                            class="InputText form-control" type="text"                             data-required="false"   maxlength="32"
                             placeholder="請輸入姓名" tit="姓名" />
                        <div   id="czg9i2e"   class="e_unit p_UnitName"></div>
                    </div>
                </div>
                
                
                                                                                                                
                                <div   id="4mp8oso"   class="e_box form-group p_GenderBox" data-ename="單選信息區">
                    <label for="c_intentionIntro" class="e_title col-sm-2 control-label d_formItemTitle h5 color_normal p_intentionIntroTitle">
                                                性別：
                    </label>
                    <div   id="nm4nmbr"   class="e_box d_CustomValueBox p_CustomValueBox">
                                                                        <div data-foreachitem class="e_radio p_sex">
                            <label class="option" for="23">
                                <input id="23" class="radio-inline" type="radio" name="item_23" value="1"
                                    checked="">
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                                                <div data-foreachitem class="e_radio p_sex">
                            <label class="option" for="23">
                                <input id="23" class="radio-inline" type="radio" name="item_23" value="2"
                                    checked="">
                                女
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                                <div   id="8sdju9r"   class="e_box form-group p_PhoneBox" data-ename="手機信息區">
                    <label for="c_intentionIntro" class="e_title col-sm-2 control-label d_formItemTitle h5 color_normal p_intentionIntroTitle">
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                    <div   id="kqw2cd4"   class="e_input p_phone" data-ename="手機輸入框">
                        <input id="" name="item_24" class="InputText form-control" maxlength="20" data-type="1"
                            data-subType="3" type="text"  data-required="false"  placeholder="請輸入手機號" tit="手機">
                    </div>
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                                <div   id="wanh8in"   class="e_box form-group p_TelephoneBox" data-ename="電話(huà)信息區">
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                    </label>
                    <div   id="eko8umn"   class="e_input p_telephone" data-ename="電話(huà)輸入框">
                        <input id="" name="item_25" class="InputText form-control" maxlength="32" data-type="1"
                            data-subType="4" type="text"  data-required="false"  placeholder="請輸入電話(huà)號碼" tit="電話(huà)">
                    </div>
                </div>
                
                
                                                                                                                
                                <div   id="y8fz88s"   class="e_box form-group p_TelephoneBox" data-ename="電話(huà)信息區">
                    <label for="c_intentionIntro" class="e_title col-sm-2 control-label d_formItemTitle h5 color_normal p_intentionIntroTitle">
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                    <div   id="d4qksrx"   class="e_input p_telephone" data-ename="電話(huà)輸入框">
                        <input id="" name="item_26" class="InputText form-control" maxlength="32" data-type="1"
                            data-subType="4" type="text"  data-required="false"  placeholder="請輸入傳真號碼" tit="傳真">
                    </div>
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                                <div   id="2kanmcm"   class="e_box form-group p_EmailBox" data-ename="郵箱信息區">
                    <label for="c_intentionIntro" class="e_title col-sm-2 control-label d_formItemTitle h5 color_normal p_intentionIntroTitle">
                                                郵箱：
                    </label>
                    <div   id="do4g938"   class="e_input p_email" data-ename="郵箱輸入框">
                        <input id="" name="item_27" class="InputText form-control" maxlength="64" data-type="1"
                            data-subType="5" type="text"  data-required="false"  placeholder="請輸入郵箱" tit="郵箱">
                    </div>
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                <div   id="zmqfg94"   class="e_box form-group p_CaptchasBox" data-ename="驗證碼">
                    
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                        <span id="x3rc8ko"    class="i_captcha"> 驗證碼：</span>                    </label>
                    
           
                    
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                            <input name="captchas" class="InputText form-control" type="input" data-required="true" value=""
                                placeholder="請輸入驗證碼" maxlength="5" tit=" 驗證碼" data-error=" 驗證碼錯誤或已失效">
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                    <div   id="ms8dxy3"   class="e_image p_image" data-ename="驗證碼圖片">
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                                <div data-foreachitem class="e_box form-group p_FullNameBox" data-ename="單行文本信息區">
                    <label for="c_intentionIntro" class="e_title col-sm-2 control-label d_formItemTitle h5 color_normal p_intentionIntroTitle">
                                                地址：
                    </label>
                    <div   id="aswedek"   class="e_input p_FullName" data-ename="單行文本輸入框">
                        <input id="" name="item_28" data-type="1" data-subType="1"
                            class="InputText form-control" type="text"                             data-required="false"   maxlength="255"  placeholder="請輸入地址" tit="地址" />
                        <div   id="srci2cw"   class="e_unit p_UnitName"></div>
                    </div>
                </div>
                
                
                                                                                                                
                                <div data-foreachitem class="e_box form-group p_FullNameBox" data-ename="單行文本信息區">
                    <label for="c_intentionIntro" class="e_title col-sm-2 control-label d_formItemTitle h5 color_normal p_intentionIntroTitle">
                                                郵編：
                    </label>
                    <div   id="rqdou8q"   class="e_input p_FullName" data-ename="單行文本輸入框">
                        <input id="" name="item_29" data-type="1" data-subType="1"
                            class="InputText form-control" type="text"                             data-required="false"   maxlength="128"
                             placeholder="請輸入郵編" tit="郵編" />
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                    <button type="button" class="btn btn-primary submitPC p_submit" data-ename="提交按鈕">提交</button>
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<p><span style="color:#333333"><span style="font-size:16px"><span style="font-family:微軟雅黑">吉林省銀諾克藥業(yè)有限公司</span></span></span></p>
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                                                <div   id="9oeks83"   class="w_ficon animated  ">  
                                                  <a href="javascript:;" class="e_link e_link-000 p_link" target="_blank" title="地址">   
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                                              </div></div>         <div   class="eag83vi"   id="content_box-1589509677540-1" class="e_box e_box-000 d_gridCell_1 p_gridCell"><div   class="n4mq9o8"   id="w_common_text-1589509677558" class="reset_style"><div><p><span style="color:#696969"><span style="font-size:14px"><span style="font-family:微軟雅黑">長(cháng)春市九臺區卡倫鎮工業(yè)園群英大路888號</span></span></span></p>
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                                                <div   id="sxedxk8"   class="w_ficon animated  ">  
                                                  <a href="javascript:;" class="e_link e_link-000 p_link" target="_blank" title="郵箱">   
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                                                <span style="font-family:微軟雅黑">留言反饋
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                                      </div><div   class="akjuu8o"   id="c_portalResMessage_form-15895097424813009" class="c_portalResMessage_form-01001"> 
<div   id="4wjpawo"   class="e_box p_inquiry" data-ename="填寫(xiě)留言表單">
        <div   id="kkou89p"   class="e_wbox p_ConWBox" data-ename="彈窗內容容器">
        
        <div   id="wbmnhh3"   class="e_box p_NameBox" data-ename="留言應用名稱(chēng)容器">
            <div   id="qvw4mp9"   class="e_title p_NameB" data-ename="名稱(chēng)標題"><span id="adxyoij"    class="i_messageCategoryName">留言應用名稱(chēng)：</span></div>
            <div   id="qy9cgvw"   class="e_title p_NameInfoB" data-ename="名稱(chēng)">客戶(hù)留言</div>
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        <div   id="xb92vko"   class="e_box p_DepictBoxB" data-ename="描述信息容器">
            <div   id="ru8f4d3"   class="e_title p_DepicNameB" data-ename="描述引導標題"><span id="o393vdk"    class="i_description">描述：</span></div>
            <div   id="wek938o"   class="e_title p_DepictInfoB" data-ename="描述"></div>
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        <form id="form" class="form-horizontal d_formItemBox p_productInfoForm" novalidate="novalidate">
            <input type="hidden" id="categoryId" class="required" name="categoryId" value="1">
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                                                留言?xún)热荩?                    </label>
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                            placeholder="請輸入留言?xún)热?  data-required="true"  tit="留言?xún)热?>

姓名：

性別：

男

女

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傳真：

郵箱：

地址：

郵編：

* 驗證碼：

驗證碼

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