document.write('<form id="form_mohsendavari" action="http://pay.azarresaneh.com/payment_saman_start.php" method=post>  <table border="0" width="100%" dir="rtl" cellspacing="0" cellpadding="0" >    <tr>      <td width="100" height="30">نام و نام خانوادگي :</td>      <td><input type="text" name="fullname" size="40" dir="rtl" lang="fa"  /><span class="need">*</span></td>    </tr>	<tr>		<td height="30"> مبلغ:</td>      <td><input type="text" name="price" size="10" dir="ltr"     /> ریال <span class="need">*</span></td>		</tr>	<tr>		<td height="30">توضیجات :</td>      <td><textarea name="note" style="width:300px;height:100px"    ></textarea><span class="need">*</span></td></tr>	<tr>    <td height="30">&nbsp;</td>    <td><input type="submit" value="ارسال درخواست" /></td>  </tr></table></form>');