document.write("<form method=post action='http://etc.sdanawa.com/script/sms/sms_mail.php' name=form>");
document.write("<div style='position:relative;text-align:left;margin-bottom:10px;'>");
document.write("<img src='http://etc.sdanawa.com/script/sms/design/1_noemail.jpg'>");
document.write("<div style='position:absolute;left:110px;top:102px;'>");
document.write("<table border='0'  cellpadding='3' cellspacing='0'>");
document.write("<tr><td><input type='text' name='damname' class='input_box1' style='width:60px;font-size:9pt;border:1px #CCCCCC solid;' value='이름' onclick=\"this.value='';\">");
document.write(" <select name='age'><option value=''>나이 </option><option value='10대'>10대</option><option value='20대'>20대</option><option value='30대'>30대</option><option value='40대'>40대</option></option><option value='50대'>50대</option></option><option value='60대'>60대</option></select>");
document.write(" <input type='text' name='area'  style='width:80px;font-size:9pt;border:1px #CCCCCC solid;' value='사는지역' onclick=\"this.value='';\"></td></tr>");
document.write("<tr><td>");
//document.write("<select name='sgr' style='width:220px;font-size:9pt;'>");

document.write('<div style="position:relative;border:1px #CCCCCC solid; width:200px;height:20px;padding:3px;">');document.write('<div style="position:absolute;border:2px #404040 solid; width:270px;height:200px;padding:3px;background-color:white;overflow-y:scroll;');document.write('font-size:9pt;cursor:pointer;left:-1px;top:-130px;display:none;" id="sms_select_form2d4c51c4c72a481"><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="0">미담성형외과</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="1">앞트임</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="2">뒤트임</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="3">매몰</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="4">절개</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="5">부분절개</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="6">눈매교정</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="7">눈밑지방제거(결막)</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="8">눈밑지방재배치</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="9">안면거상</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="10">눈썹거상</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="11">Acculift</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="12">안검하수</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="13">상안검</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="14">하안검 지방제거</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="15">하안검 지방재배치</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="16">코전체(보형)</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="17">코(진피이식)</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="18">매부리코</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="19">휜코</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="20">복코(주먹코)</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="21">콧볼줄임</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="22">사각턱축소</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="23">광대축소</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="24">무턱교정(보형물)</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="25">이마(보형물)</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="26">귀족수술(보형물)</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="27">가슴확대(코젤)</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="28">지방이식부위별</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="29">지방이식풀</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="30">흉터1cm센티</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="31">흉터복합치료</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="32">보톡스(눈가,or이마or미간)</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="33">미니페이스 소프트</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="34">미니페이스 파워</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="35">필러 콧대</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="36">필러(부위별)</dl><dl style="padding:3px;margin:0px;width:100%;height:20px;overflow:hidden;" onclick="');document.write('document.getElementById(\'sms_select_form1d4c51c4c72a481\').innerHTML=this.innerHTML;');document.write('document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'none\';');document.write('document.getElementById(\'sms_select_form3d4c51c4c72a481\').value=this.rel;');document.write('" rel="37">겨드랑이제모</dl></div>');document.write('<span id="sms_select_form1d4c51c4c72a481" style="cursor:pointer;width:100%;font-size:9pt;" onclick="document.getElementById(\'sms_select_form2d4c51c4c72a481\').style.display=\'\';">여기를 클릭하세요</span>');document.write('</div>');document.write('<input type=hidden name="sgr" id="sms_select_form3d4c51c4c72a481">');

//document.write("</select>");
document.write("</td></tr>");
document.write("<tr><td>");
document.write("<select name='phone1' size=1  class='input_box1'>");
document.write("		<option value='010' selected>010</option>");
document.write("		<option value='011'>011</option>");
document.write("		<option value='016'>016</option>");
document.write("		<option value='017'>017</option>");
document.write("		<option value='018'>018</option>");
document.write("		<option value='019'>019</option>");
document.write("		</select>");
document.write("	   - ");
document.write("	   <input name='phone2' type=text   class='input_box1' style='width:50px;font-size:9pt;border:1px #CCCCCC solid;'> - ");
document.write("	   <input name='phone3' type=text   class='input_box1' style='width:50px;font-size:9pt;border:1px #CCCCCC solid;'>");
document.write("</td></tr>");
document.write("<tr><td>");
//document.write("<input name='email' type=text   class='input_box1' style='width:170px;'> ");
document.write("</td></tr>");
document.write("<tr><td> ");

document.write(" <br>");

document.write("<input type='submit' value='비용 문자 받기!'><input type='hidden' name='clinic' value='midam'><input type='hidden' name='charset' value=''>");
document.write("</td></tr>");
document.write("</table>");
document.write("<div style='position:absolute;left:240px;top:0px;'><input type=image src='http://uccat.inapips.com/img/blank.gif' width=180 height=90></div></div>");
document.write("</div>");
document.write("</form>");