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山東省青島市城陽(yáng)區城陽(yáng)街道前旺疃村

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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="95pzhvr"   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="tn55jzd"   class="e_unit p_UnitName"></div>
                    </div>
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                                <div   id="xbnznzp"   class="e_box form-group p_GenderBox" data-ename="單選信息區">
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                                                性別：
                    </label>
                    <div   id="xflv5lr"   class="e_box d_CustomValueBox p_CustomValueBox">
                                                                        <div data-foreachitem class="e_radio p_sex">
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                                <input id="23" class="radio-inline" type="radio" name="item_23" value="1"
                                    checked="">
                                男
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                                                <div data-foreachitem class="e_radio p_sex">
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                                    checked="">
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                                <div   id="ff5ljvp"   class="e_box form-group p_PhoneBox" data-ename="手機信息區">
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                                <div data-foreachitem class="e_box form-group p_FullNameBox" data-ename="單行文本信息區">
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                            class="InputText form-control" type="text"                             data-required="false"   maxlength="255"  placeholder="請輸入地址" tit="地址" />
                        <div   id="rhr5j5z"   class="e_unit p_UnitName"></div>
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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">
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                        <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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                <div   id="95515j5"   class="e_box form-group p_CaptchasBox" data-ename="驗證碼">
                    
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                        <div   id="lz5vrtv"   class="e_input p_EntryInput" data-ename="驗證碼輸入框">
                            
                            <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">
                        </div>
                        
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                    <div   id="tdpt5x1"   class="e_image p_image" data-ename="驗證碼圖片">
                        <img src="" width="100%" height="100%" alt="驗證碼">
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                <div   id="d5d5fnn"   class="e_wbox p_CoupWBox">
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                            </div>
            
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