document.write('<div id="out_table">');
document.write('<form action="//blog.tenkomori.tv/survey_result.php" method="post"><input type="hidden" name="csrf" value="70391deebf551bafee4e92cd007a8216390d215f" />');
document.write('<div id="survey_title">');
document.write('GWにしたいこと');
document.write('</div>');
document.write('<div id="survey_time">2012/04/23～2012/05/07</div>');
document.write('<div id="survey_brief">気づけばもうすぐＧＷ。<br />皆さんはどこかお出かけする予定はありますか？（・∀・）<br />久々の大型連休、お家でまったりするも良し。どこかお出かけするも良し…。<br /><br />皆さんがＧＷにしたいことをポチッと一票、お願いします！m9（・∀・）</div>');
document.write('<table class="survey_vote">');
document.write('<tr class="survey_vote"><td class="survey_vote"></td><td class="survey_vote"><label for="0">旅行（国内）</label></td></tr><tr class="survey_vote"><td class="survey_vote"></td><td class="survey_vote"><label for="1">旅行（海外）</label></td></tr><tr class="survey_vote"><td class="survey_vote"></td><td class="survey_vote"><label for="2">掃除</label></td></tr><tr class="survey_vote"><td class="survey_vote"></td><td class="survey_vote"><label for="3">読者</label></td></tr><tr class="survey_vote"><td class="survey_vote"></td><td class="survey_vote"><label for="4">その他</label></td></tr>');
document.write('</table>');
document.write('');
document.write('<div id="vote_button">');
document.write('<p class="bt"></p>');
document.write('<p class="more"><a href="//blog.tenkomori.tv/survey_result.php?id=77">投票結果を見る</a></p>');
document.write('</div>');
document.write('<input type="hidden" name="id" value="77">');
document.write('</form>');
document.write('</div>');