birjudave
10-17-2007, 03:05 AM
Hi,
I am completely new here and this question might reallu sound stupid but, I really need help regarding this as soon as possible..
I have created a form and I want to display the results of selected checkboxes, radio buttons , drop downs etc.... on a text box either on the same window or a diffrent window....How do i go about doing it...?
below mentions is the form i have created...thanks...
<html>
<head>
<title>TSO Notes</title>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">
<link rel="stylesheet" href="style.css" type="text/css">
</head>
<td valign="top" rowspan="0" align="left" colspan="0"><img src="images/suth_logo.gif" width="194" height="82"></td>
<td valign="top" rowspan="0" align="right" colspan="0"><img src="images/logo.jpg" width="600" height="82"></td>
<td valign="top" rowspan="0" align="right" colspan="0"><img src="images/Con_logo.jpg" width="150" height="82"></td>
<tr>
<td></td>
</tr>
<tr>
<td valign="bottom" height="40" align="right"> <font color="004591"> </font></td>
<td></td>
</tr>
<tr>
<td valign="top" rowspan="5"> </td>
<td valign="top" bgcolor="#AACDF0" height="52" colspan="2"> </td>
<td></td>
</tr>
<tr>
<td height="19" valign="top" class="link" colspan="2"> </td>
<td></td>
</tr>
<tr>
<td valign="top" width="18"> </td>
<td></td>
</tr>
<tr>
<td rowspan="3" colspan="2" valign="top">
<form name="form1" method="get" action="bir.html">
<table width="100%" align="right">
<td height="19" align="center" valign="middle" colspan="3" bgcolor="#CCCCCC"><font color="004591"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b> Fields
marked with</b></font></font><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b>
*<font color="004591"> are mandatory</font></b></font></td>
</tr>
<tr>
<td align="right" height="19" bgcolor="#E4E4E4" valign="middle"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b><font color="#9B280A">TSO's Name</font></b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"> <b><font size="1" face="Verdana, Arial, Helvetica, sans-serif">*</font></b></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"><font color="#DBDBDB">
<input type="text" name="textfield">
</font></td>
</tr>
<tr>
<td align="right" height="19" bgcolor="#E4E4E4" valign="middle"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b><font color="#9B280A">Alias</font></b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"> <b><font size="1" face="Verdana, Arial, Helvetica, sans-serif">*</font></b></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"><font color="#DBDBDB">
<input type="text" name="textfield">
</font></td>
</tr>
<tr>
<td align="right" height="28" bgcolor="#E4E4E4" valign="middle"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b><font color="#9B280A">DSL
Number</font></b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4" height="28"><b><font size="1" face="Verdana, Arial, Helvetica, sans-serif">*</font></b></td>
<td align="left" valign="middle" bgcolor="#E4E4E4" height="28"><font color="#DBDBDB">
<input type="text" name="textfield2">
</font></td>
</tr>
<tr>
<td align="right" bgcolor="#E4E4E4" valign="middle"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b><font color="#9B280A">Caller's
Name</font></b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"><b><font size="1" face="Verdana, Arial, Helvetica, sans-serif">*</font></b></td>
<td align="left" valign="middle" bgcolor="#E4E4E4">
<input type="text" name="textfield3">
<tr>
<td height="8" align="right" valign="top" colspan="3"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"></font><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b> </b></font></td>
</tr>
<tr>
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Verification
Done</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b>
<input type="radio" name="Brochure" value="radiobutton">
Yes
<input type="radio" name="Brochure" value="radiobutton">
No
<input type="radio" name="Brochure" value="radiobutton">
N/A
</b></font></td>
</tr>
</td>
</tr>
<tr>
<tr>
<td align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Select
Modem</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"><b><font size="1" face="Verdana, Arial, Helvetica, sans-serif">*</font></b></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"> <font color="#DBDBDB">
<select name="select">
<option value="6" selected>Select</option>
<option value="1">Westell 2100/2200</option>
<option value="2">Westell 6100</option>
<option value="3">Westell 327W</option>
<option value="4">Netopia 2241</option>
<option value="5">2 Wire (Shasta)</option>
<option value="7">2 Wire (Boss)</option>
<option value="7">Netopia 3347 NWG</option>
<option value="7">Netopia 3347W</option>
<option value="7">Netopia 3346</option>
<option value="7">Cayman 3220H</option>
</select>
</font></td>
</tr>
<tr>
<td align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Select
Issue</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"><b><font size="1" face="Verdana, Arial, Helvetica, sans-serif">*</font></b></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"> <font color="#DBDBDB">
<select name="select">
<option value="6" selected>Select</option>
<option value="1">3rd Part Router</option>
<option value="2">Account Maintenance</option>
<option value="3">Appointment Status</option>
<option value="4">Email Configuration</option>
<option value="5">Email Send/Receive</option>
<option value="7">Ghost Call</option>
<option value="7">HN Congiguration</option>
<option value="7">HN Troubleshooting</option>
<option value="7">Installation Status</option>
<option value="7">Intermittent Connectivity</option>
<option value="7">No Surf</option>
<option value="7">No Sync</option>
<option value="7">Ordered Status</option>
<option value="7">Outage</option>
<option value="7">PC Issue</option>
<option value="7">Portal/Application</option>
<option value="7">Provisioning Status</option>
<option value="7">Product Information</option>
<option value="7">Slow Speed</option>
<option value="7">Webmail Issues</option>
<option value="7">Billing Issues</option>
<option value="7">ATTIS</option>
</select>
</font></td>
</tr>
<tr align="center">
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>FTP Results</b></font></td>
<td valign="top" align="right" bgcolor="#E4E4E4"> </td>
<td valign="middle" align="left" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif">
<textarea rows="2" name="Comments" cols="20" class=".typebox"></textarea>
</font></td>
</tr>
<tr>
<td height="8" align="right" valign="top" colspan="3"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"></font><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b> </b></font></td>
</tr>
<tr>
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b> DSL
Light</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b>
<input type="radio" name="Brochure" value="radiobutton">
Solid Green
<input type="radio" name="Brochure" value="radiobutton">
Flashing Green
<input type="radio" name="Brochure" value="radiobutton">
Turned Off
</b></font></td>
</tr>
<tr>
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Powercycled
CPE</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"> </td>
<td align="left" valign="middle" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b> Yes
<input type="radio" name="Call back" value="radiobutton" checked>
No
<input type="radio" name="Call back" value="radiobutton">
</b></font></td>
</tr>
<tr>
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Checked
SOEG</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b> Yes
<input type="radio" name="representative" value="radiobutton">
No
<input type="radio" name="representative" value="radiobutton" checked>
</b></font></td>
</tr>
<tr>
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Reset
TCP/IP</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b> Yes
<input type="radio" name="representative" value="radiobutton">
No
<input type="radio" name="representative" value="radiobutton" checked>
</b></font></td>
</tr>
<tr>
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Reinstalled
Modem Drivers</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b> Yes
<input type="radio" name="representative" value="radiobutton">
No
<input type="radio" name="representative" value="radiobutton" checked>
</b></font></td>
</tr>
<tr>
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Reset
Winsock Catalog</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b> Yes
<input type="radio" name="representative" value="radiobutton">
No
<input type="radio" name="representative" value="radiobutton" checked>
</b></font></td>
</tr>
<tr>
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Browser
Optimization</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b> Yes
<input type="radio" name="representative" value="radiobutton">
No
<input type="radio" name="representative" value="radiobutton" checked>
</b></font></td>
</tr>
<tr>
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Send
Technician</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b> Yes
<input type="radio" name="representative" value="radiobutton">
No
<input type="radio" name="representative" value="radiobutton" checked>
</b></font></td>
</tr>
<tr>
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b>First
Call Resolution</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"></td>
<td align="left" valign="middle" bgcolor="#E4E4E4">
<input type="checkbox" name="checkbox" value="checkbox" checked>
</td>
</tr>
<tr align="center">
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>BOSS Aritcle ID :</b></font></td>
<td valign="top" align="right" bgcolor="#E4E4E4"> </td>
<td valign="middle" align="left" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif">
<textarea rows="1" name="Comments" cols="15" class=".typebox"></textarea>
</font></td>
</tr>
<tr align="center">
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Additional Comments</b></font></td>
<td valign="top" align="right" bgcolor="#E4E4E4"> </td>
<td valign="middle" align="left" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif">
<textarea rows="4" name="Comments" cols="40" class=".typebox"></textarea>
</font></td>
</tr>
<tr>
<td height="19" align="center" valign="middle" colspan="3">
<input type="submit" name="Submit" value="Submit">
<input type="reset" name="Reset" value="Reset">
</td>
</tr>
</table>
</form>
</td>
<td height="208"></td>
</tr>
<tr>
<td height="279"></td>
<td></td>
</tr>
<tr>
<td height="144"></td>
<td></td>
<td></td>
</tr>
<td></td>
</table>
</body>
</html>
I am completely new here and this question might reallu sound stupid but, I really need help regarding this as soon as possible..
I have created a form and I want to display the results of selected checkboxes, radio buttons , drop downs etc.... on a text box either on the same window or a diffrent window....How do i go about doing it...?
below mentions is the form i have created...thanks...
<html>
<head>
<title>TSO Notes</title>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">
<link rel="stylesheet" href="style.css" type="text/css">
</head>
<td valign="top" rowspan="0" align="left" colspan="0"><img src="images/suth_logo.gif" width="194" height="82"></td>
<td valign="top" rowspan="0" align="right" colspan="0"><img src="images/logo.jpg" width="600" height="82"></td>
<td valign="top" rowspan="0" align="right" colspan="0"><img src="images/Con_logo.jpg" width="150" height="82"></td>
<tr>
<td></td>
</tr>
<tr>
<td valign="bottom" height="40" align="right"> <font color="004591"> </font></td>
<td></td>
</tr>
<tr>
<td valign="top" rowspan="5"> </td>
<td valign="top" bgcolor="#AACDF0" height="52" colspan="2"> </td>
<td></td>
</tr>
<tr>
<td height="19" valign="top" class="link" colspan="2"> </td>
<td></td>
</tr>
<tr>
<td valign="top" width="18"> </td>
<td></td>
</tr>
<tr>
<td rowspan="3" colspan="2" valign="top">
<form name="form1" method="get" action="bir.html">
<table width="100%" align="right">
<td height="19" align="center" valign="middle" colspan="3" bgcolor="#CCCCCC"><font color="004591"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b> Fields
marked with</b></font></font><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b>
*<font color="004591"> are mandatory</font></b></font></td>
</tr>
<tr>
<td align="right" height="19" bgcolor="#E4E4E4" valign="middle"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b><font color="#9B280A">TSO's Name</font></b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"> <b><font size="1" face="Verdana, Arial, Helvetica, sans-serif">*</font></b></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"><font color="#DBDBDB">
<input type="text" name="textfield">
</font></td>
</tr>
<tr>
<td align="right" height="19" bgcolor="#E4E4E4" valign="middle"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b><font color="#9B280A">Alias</font></b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"> <b><font size="1" face="Verdana, Arial, Helvetica, sans-serif">*</font></b></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"><font color="#DBDBDB">
<input type="text" name="textfield">
</font></td>
</tr>
<tr>
<td align="right" height="28" bgcolor="#E4E4E4" valign="middle"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b><font color="#9B280A">DSL
Number</font></b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4" height="28"><b><font size="1" face="Verdana, Arial, Helvetica, sans-serif">*</font></b></td>
<td align="left" valign="middle" bgcolor="#E4E4E4" height="28"><font color="#DBDBDB">
<input type="text" name="textfield2">
</font></td>
</tr>
<tr>
<td align="right" bgcolor="#E4E4E4" valign="middle"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b><font color="#9B280A">Caller's
Name</font></b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"><b><font size="1" face="Verdana, Arial, Helvetica, sans-serif">*</font></b></td>
<td align="left" valign="middle" bgcolor="#E4E4E4">
<input type="text" name="textfield3">
<tr>
<td height="8" align="right" valign="top" colspan="3"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"></font><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b> </b></font></td>
</tr>
<tr>
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Verification
Done</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b>
<input type="radio" name="Brochure" value="radiobutton">
Yes
<input type="radio" name="Brochure" value="radiobutton">
No
<input type="radio" name="Brochure" value="radiobutton">
N/A
</b></font></td>
</tr>
</td>
</tr>
<tr>
<tr>
<td align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Select
Modem</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"><b><font size="1" face="Verdana, Arial, Helvetica, sans-serif">*</font></b></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"> <font color="#DBDBDB">
<select name="select">
<option value="6" selected>Select</option>
<option value="1">Westell 2100/2200</option>
<option value="2">Westell 6100</option>
<option value="3">Westell 327W</option>
<option value="4">Netopia 2241</option>
<option value="5">2 Wire (Shasta)</option>
<option value="7">2 Wire (Boss)</option>
<option value="7">Netopia 3347 NWG</option>
<option value="7">Netopia 3347W</option>
<option value="7">Netopia 3346</option>
<option value="7">Cayman 3220H</option>
</select>
</font></td>
</tr>
<tr>
<td align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Select
Issue</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"><b><font size="1" face="Verdana, Arial, Helvetica, sans-serif">*</font></b></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"> <font color="#DBDBDB">
<select name="select">
<option value="6" selected>Select</option>
<option value="1">3rd Part Router</option>
<option value="2">Account Maintenance</option>
<option value="3">Appointment Status</option>
<option value="4">Email Configuration</option>
<option value="5">Email Send/Receive</option>
<option value="7">Ghost Call</option>
<option value="7">HN Congiguration</option>
<option value="7">HN Troubleshooting</option>
<option value="7">Installation Status</option>
<option value="7">Intermittent Connectivity</option>
<option value="7">No Surf</option>
<option value="7">No Sync</option>
<option value="7">Ordered Status</option>
<option value="7">Outage</option>
<option value="7">PC Issue</option>
<option value="7">Portal/Application</option>
<option value="7">Provisioning Status</option>
<option value="7">Product Information</option>
<option value="7">Slow Speed</option>
<option value="7">Webmail Issues</option>
<option value="7">Billing Issues</option>
<option value="7">ATTIS</option>
</select>
</font></td>
</tr>
<tr align="center">
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>FTP Results</b></font></td>
<td valign="top" align="right" bgcolor="#E4E4E4"> </td>
<td valign="middle" align="left" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif">
<textarea rows="2" name="Comments" cols="20" class=".typebox"></textarea>
</font></td>
</tr>
<tr>
<td height="8" align="right" valign="top" colspan="3"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"></font><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b> </b></font></td>
</tr>
<tr>
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b> DSL
Light</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b>
<input type="radio" name="Brochure" value="radiobutton">
Solid Green
<input type="radio" name="Brochure" value="radiobutton">
Flashing Green
<input type="radio" name="Brochure" value="radiobutton">
Turned Off
</b></font></td>
</tr>
<tr>
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Powercycled
CPE</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"> </td>
<td align="left" valign="middle" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b> Yes
<input type="radio" name="Call back" value="radiobutton" checked>
No
<input type="radio" name="Call back" value="radiobutton">
</b></font></td>
</tr>
<tr>
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Checked
SOEG</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b> Yes
<input type="radio" name="representative" value="radiobutton">
No
<input type="radio" name="representative" value="radiobutton" checked>
</b></font></td>
</tr>
<tr>
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Reset
TCP/IP</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b> Yes
<input type="radio" name="representative" value="radiobutton">
No
<input type="radio" name="representative" value="radiobutton" checked>
</b></font></td>
</tr>
<tr>
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Reinstalled
Modem Drivers</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b> Yes
<input type="radio" name="representative" value="radiobutton">
No
<input type="radio" name="representative" value="radiobutton" checked>
</b></font></td>
</tr>
<tr>
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Reset
Winsock Catalog</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b> Yes
<input type="radio" name="representative" value="radiobutton">
No
<input type="radio" name="representative" value="radiobutton" checked>
</b></font></td>
</tr>
<tr>
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Browser
Optimization</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b> Yes
<input type="radio" name="representative" value="radiobutton">
No
<input type="radio" name="representative" value="radiobutton" checked>
</b></font></td>
</tr>
<tr>
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Send
Technician</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"></td>
<td align="left" valign="middle" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b> Yes
<input type="radio" name="representative" value="radiobutton">
No
<input type="radio" name="representative" value="radiobutton" checked>
</b></font></td>
</tr>
<tr>
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif"><b>First
Call Resolution</b></font></td>
<td align="right" valign="top" bgcolor="#E4E4E4"></td>
<td align="left" valign="middle" bgcolor="#E4E4E4">
<input type="checkbox" name="checkbox" value="checkbox" checked>
</td>
</tr>
<tr align="center">
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>BOSS Aritcle ID :</b></font></td>
<td valign="top" align="right" bgcolor="#E4E4E4"> </td>
<td valign="middle" align="left" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif">
<textarea rows="1" name="Comments" cols="15" class=".typebox"></textarea>
</font></td>
</tr>
<tr align="center">
<td height="19" align="right" valign="middle" bgcolor="#E4E4E4"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b>Additional Comments</b></font></td>
<td valign="top" align="right" bgcolor="#E4E4E4"> </td>
<td valign="middle" align="left" bgcolor="#E4E4E4"><font size="1" face="Verdana, Arial, Helvetica, sans-serif">
<textarea rows="4" name="Comments" cols="40" class=".typebox"></textarea>
</font></td>
</tr>
<tr>
<td height="19" align="center" valign="middle" colspan="3">
<input type="submit" name="Submit" value="Submit">
<input type="reset" name="Reset" value="Reset">
</td>
</tr>
</table>
</form>
</td>
<td height="208"></td>
</tr>
<tr>
<td height="279"></td>
<td></td>
</tr>
<tr>
<td height="144"></td>
<td></td>
<td></td>
</tr>
<td></td>
</table>
</body>
</html>