document.writeln('<form id="login" name="frm_login" method="post" action="/login.php" onsubmit="return login_check();"><table border="0" cellspacing="0" cellpadding="0"><tr class="tahtxt"><td class="bltxt">Patient Login</td><td width="10"></td><td>Email</td><td width="5"></td><td><input name="email" type="text" id="email" size="15" /></td><td width="10"></td><td>Password</td><td width="5"></td><td><input name="password" type="password" id="password" size="15" /></td><td width="10"></td><td><input type="hidden" name="login" value="y"><input name="login" type="image" src="/images/loginbtn.gif" class="nostyle" /></td><td width="10"></td><td>&bull; <a href="/forgotpassword.php">Forgot Password?</a></td></tr></table></form>');