document.write('<div id="out_table">');
document.write('<form action="//amamin.jp/survey_result.php" method="post"><input type="hidden" name="csrf" value="1b51e1e29d235d28bfa1faf34be2ac52adfc824e" />');
document.write('<div id="survey_title">');
document.write('チョコもらった？');
document.write('</div>');
document.write('<div id="survey_time">2011/02/15～2011/02/28</div>');
document.write('<div id="survey_brief">今年のバレンタインデーチョコは何個もらいましたか？</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">10個以上</label></td></tr><tr class="survey_vote"><td class="survey_vote"></td><td class="survey_vote"><label for="1">9個</label></td></tr><tr class="survey_vote"><td class="survey_vote"></td><td class="survey_vote"><label for="2">8個</label></td></tr><tr class="survey_vote"><td class="survey_vote"></td><td class="survey_vote"><label for="3">7個</label></td></tr><tr class="survey_vote"><td class="survey_vote"></td><td class="survey_vote"><label for="4">6個</label></td></tr><tr class="survey_vote"><td class="survey_vote"></td><td class="survey_vote"><label for="5">5個</label></td></tr><tr class="survey_vote"><td class="survey_vote"></td><td class="survey_vote"><label for="6">4個</label></td></tr><tr class="survey_vote"><td class="survey_vote"></td><td class="survey_vote"><label for="7">3個</label></td></tr><tr class="survey_vote"><td class="survey_vote"></td><td class="survey_vote"><label for="8">2個</label></td></tr><tr class="survey_vote"><td class="survey_vote"></td><td class="survey_vote"><label for="9">1個</label></td></tr><tr class="survey_vote"><td class="survey_vote"></td><td class="survey_vote"><label for="10">もらわなかった（泣）</label></td></tr>');
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document.write('<p class="bt"></p>');
document.write('<p class="more"><a href="//amamin.jp/survey_result.php?id=13&page=5">投票結果を見る</a></p>');
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document.write('<input type="hidden" name="id" value="13">');
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