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::: <div id="in4v-2" class="container"><div id="id-2" class="container-fluid px-0 w-100 mt-3"><div id="in4v"><div id="it8aqs" data-block-name="vips-titles" class="cbt_40310 d-flex align-items-center justify-content-center"><img id="iusw5r" src="/upload/htmlConten/fdbd47fe-de49-42f4-bcc4-993b79cd6f90.avif?v=f61bf71a9dca4e560e29afd9308ab8704896995b71c4c280e6bd2f92492cfee8"><div id="i5pft3"> 《個人健診》線上預約 </div></div><div id="ib1tg" class="container"><div id="iq6wh6" class="btn-group-container"><!-- 線上預約按鈕 --><div id="ilpuh" class="appointment-row"><a href="/vipms/testitems" id="inmgl" target="_blank" title="連結檢查項目連結" class="custom-btn btn-appointment"><span class="material-symbols-outlined">calendar_month</span> 檢查項目連結 </a></div></div><div id="iq6wh6-2" data-key="" class="btn-group-container"><!-- 線上預約按鈕 --><div id="i46w1s" data-key="" class="appointment-row"><a href="https://line.me/R/ti/p/xPSVMuibOB" target="_blank" title="加line預約" id="iahli" class="custom-btn btn-line"><span class="material-symbols-outlined">chat</span>加 LINE 預約 </a></div></div><div custom_block_template="true" block_id="customBlockTemplate_70703" id="irohf" data-block-name="敏盛Line預約" class="text-center mt-3"><div id="i3rz1" class="businessHours"><span id="iacdjo" class="text-danger fw-bold">重要提醒:LINE和線上預約擇一即可(切勿重覆預約)<br></span><strong></strong></div></div><div id="i80ib" class="row justify-content-center"><div id="iein8" class="col-12 col-md-8 col-lg-12"><div id="ioejt" class="py-3"><!-- 上方線條 --><div class="divider-line mb-4"> </div><!-- 主要內容 --><div class="text-center"><p id="ie4gx" class="fs-6 lh-base text-dark mb-2">親愛的貴賓提醒您~我們無法受理【請勿在此預約😅】公教4500元以下專案 、新進人員、勞工、供膳、保險、學生、收養、入住安養院或政府補助等相關檢查 </p><p id="ia60h" class="fs-6 lh-base text-dark mb-0">以上檢查煩請您洽詢 B1 國人健檢 ☎ 03-3179599 轉 7121,由衷感謝您的配合 ❤️ </p></div><!-- 下方線條 --><div id="irpuj" class="divider-line mt-4"> </div></div></div></div></div><div custom_block_template="true" block_id="customBlockTemplate_70709" id="ixg0u-2" class="gjs-row contact-row"><div id="ito2o-2" class="gjs-cell contact-cell"><form id="ContactForm" method="post" novalidate="" class="bg-white rounded needs-validation p-sm-3 ContactForm contact-form col"><input name="authentiity_token" type="hidden" value="@Model.token"><input data-title="精準醫學健診中心客服人員" name="sender" type="hidden" value="A001348@e-ms.com.tw"><div custom_block_template="true" block_id="customBlockTemplate_1" id="in4v-3" class="container"><!-- Content here --><div id="ibxpm-2" class="contact-grid two-col"><div class="contact-field text-field required-field form-floating"><label for="InputName" class="contact-label required">姓 名</label><input id="InputName" name="name" placeholder="" required="" type="text" class="form-control"><div class="invalid-feedback">請輸入姓名 </div></div><div id="iyesd" class="contact-field choice-field required-field gender-field form-floating"><div class="contact-label required title">稱 謂 </div><div class="choice-list inline-choice-list d-flex"><div id="ibp6s" class="form-check choice-item"><input id="GenderSir" name="Gender" required="" type="radio" value="先生" class="form-check-input"><label for="GenderSir" id="idhbl" class="form-check-label">先生</label></div><div class="form-check choice-item"><input id="GenderMiss" name="Gender" required="" type="radio" value="小姐" class="form-check-input"><label for="GenderMiss" id="icw45" class="form-check-label">小姐</label></div></div><div class="invalid-feedback">請選擇稱謂 </div></div></div><div id="icauf" class="contact-grid two-col"><div class="contact-field text-field required-field form-floating"><label for="InputEmail" class="contact-label required">Email</label><input id="InputEmail-2" name="email" placeholder="" required="" type="email" class="form-control"><div id="i2pqx" class="invalid-feedback">請輸入電子郵件 </div></div><div class="contact-field text-field required-field form-floating"><label for="InputPhone" id="i3de55" class="contact-label required">聯絡電話</label><input id="InputPhone" maxlength="11" name="telPhone" pattern="[0]\d*" placeholder="" required="" type="tel" class="form-control"><div class="invalid-feedback">請輸入正確的電話格式 </div></div></div><div id="infhmp" class="contact-field text-field required-field full-line form-floating"><label for="InputCompany" id="i60o6f" class="contact-label required">聯絡地址</label><input id="InputCompany" name="InputCompany" placeholder="" required="" type="text" class="form-control"><div class="invalid-feedback">請輸入服務單位 </div></div><div id="iogfah" data-key="" class="contact-field text-field required-field full-line form-floating"><label id="ibrl4r" data-key="" class="contact-label required">身分證字號</label><input id="InputCompany-2" name="idno" data-key="" class="form-control"><div id="i5hi4k" data-key="" class="invalid-feedback">請輸入服務單位 </div></div><div id="iqe0b" class="contact-grid two-col"><div class="contact-field date-field required-field date-short form-floating"><label for="InputBirthday" class="contact-label required">出生年月日</label><input id="InputBirthday" name="birthday" placeholder="yyyy-mm-dd" required="" type="date" class="form-control"><div class="invalid-feedback">請選擇生日日期 </div></div><div id="iyqm0u" class="contact-field date-field required-field date-long appointment-date-field form-floating"><label for="InputCheckDate" id="ijb55w" class="contact-label required">希望預約日期</label><input id="InputCheckDate" name="checkDate" placeholder="yyyy-mm-dd" required="" type="date" class="form-control"><div id="iakhlt" class="memo">待諮詢人員聯繫後方可確認~ </div><div class="invalid-feedback">請選擇希望預約日期 </div></div></div><div id="i3ux0q" class="call d-flex flex-column checkbox_father_config contact-group compact-choice-group fit-check-table"><div id="il28a7" class="contact-group-body"><div id="istdcg" class="required title contact-group-title">健檢原因 </div><div class="d-flex ms-3 flex-md-row flex-column four_button contact-options two-options"><div id="iafacq" class="form-check choice-item"><input id="RadioFormYes" name="RadioForm" type="radio" value="是" class="form-check-input"><label for="RadioFormYes" id="iq5jm1" class="form-check-label">身體不適</label></div><div class="form-check choice-item"><input id="RadioFormNo" name="RadioForm" type="radio" value="否" class="form-check-input"><label for="RadioFormNo" id="idi4kl" class="form-check-label">定期健檢</label></div></div></div></div><div id="iuq0uz" class="contact-field select-field required-field plan-field form-floating"><div id="it2c99" class="select-label-wrap"><label for="ContactUsType" id="ii4knr" class="contact-label required">健診方案</label></div><div id="ikqwg8" class="select-input-wrap"><select data-dynamic-select="1" id="ContactUsType" name="ContactUsType" required="" class="form-select"><option value="">---請選擇---</option><option value="①標準A.專科超音波:15,000元">①標準A.專科超音波:15,000元</option><option value="②標準B.肺部:15,000元">②標準B.肺部:15,000元</option><option value="③標準C.心臟鈣化:15,000元">③標準C.心臟鈣化:15,000元</option><option value="④精緻A.無痛腸胃:♂男25,000;♀女28,000元起">④精緻A.無痛腸胃:♂男25,000;♀女28,000元起</option><option value="⑤精緻B.腦部:♂男25,000;♀女28,000元起">⑤精緻B.腦部:♂男25,000;♀女28,000元起</option><option value="⑥精緻C.心肺:♂男25,000;♀女28,000元起">⑥精緻C.心肺:♂男25,000;♀女28,000元起</option><option value="⑦進階方案:♂男37,000;♀女38,500元起">⑦進階方案:♂男37,000;♀女38,500元起</option><option value="⑧高階方案:♂男50,000;♀女56,000元起">⑧高階方案:♂男50,000;♀女56,000元起</option><option value="⑨全方位方案:♂男100,000;♀女106,000元起">⑨全方位方案:♂男100,000;♀女106,000元起</option><option value="⑩腦心肺檢查">⑩腦心肺檢查</option><option value="⑪2026母親節健診方案">⑪2026母親節健診方案</option><option value="⑫其他">⑫其他</option></select></div></div></div><div id="iudtvj" class="call d-flex flex-column checkbox_father_config contact-group required-choice-group"><div custom_block_template="true" block_id="customBlockTemplate_1" id="in4v-4" class="container"><!-- Content here --><div id="ikzz8k-2-2-3" data-key="" class="call d-flex flex-column checkbox_father_config contact-group required-choice-group fit-check-table"><div custom_block_template="true" block_id="customBlockTemplate_36" id="i582" draggable="true" class="custom_h3"><b>個人健康狀況 </b></div><div id="iig0vn-2" class="contact-group-body"><div id="iwh36t-2" class="title required contact-group-title question-title">1️⃣過去病史 </div><div class="group-feedback invalid-feedback">請選擇病史 </div><div class="d-flex ms-3 flex-md-row flex-column four_button contact-options"><div class="form-check choice-item"><input data-exclusive="" id="Sick1None" name="sick1" type="checkbox" value="無" class="form-check-input"><label for="Sick1None" class="form-check-label">無</label></div><div class="form-check choice-item"><input id="Sick1Hypertension" name="sick1" type="checkbox" value="高血壓" class="form-check-input"><label for="Sick1Hypertension" class="form-check-label">高血壓</label></div><div class="form-check choice-item"><input id="Sick1Diabetes" name="sick1" type="checkbox" value="糖尿病" class="form-check-input"><label for="Sick1Diabetes" class="form-check-label">糖尿病</label></div><div id="io0fnb" class="form-check choice-item"><input id="Sick1KidneyDisease" name="sick1" type="checkbox" value="腎臟病" class="form-check-input"><label for="Sick1KidneyDisease" class="form-check-label">腎臟病</label></div><div class="form-check pe-3 checkbox_input_text choice-item other-choice"><input id="Sick1Other" name="sick1" type="checkbox" value="其他" class="form-check-input"><label for="Sick1Other" class="form-check-label flex-none">其他</label><input aria-label="其他補充說明" data-for="Sick1Other" id="Sick1OtherText" name="sick1_th" type="text" class="form-control border-0 border-bottom bg-transparent px-1 py-0 shadow-none checkbox_form_control"></div></div></div></div><div id="ikzz8k-2-2-2" data-key="" class="call d-flex flex-column checkbox_father_config contact-group required-choice-group fit-check-table"><div id="iommgc-2" class="contact-group-body"><div class="title required contact-group-title question-title">2️⃣用藥紀錄 </div><div class="group-feedback invalid-feedback">請選擇用藥紀錄 </div><div class="d-flex ms-3 flex-md-row flex-column four_button contact-options"><div class="form-check choice-item"><input data-exclusive="" id="Sick12None-2" name="sick12" type="checkbox" value="無" class="form-check-input"><label for="Sick12None-2" class="form-check-label">無</label></div><div class="form-check choice-item"><input id="Sick12Hypertension-2" name="sick12" type="checkbox" value="高血壓" class="form-check-input"><label for="Sick12Hypertension-2" class="form-check-label">高血壓</label></div><div class="form-check choice-item"><input id="Sick12Diabetes-2" name="sick12" type="checkbox" value="糖尿病" class="form-check-input"><label for="Sick12Diabetes-2" class="form-check-label">糖尿病</label></div><div class="form-check choice-item"><input id="Sick12Anticoagulant-2" name="sick12" type="checkbox" value="抗凝血藥物" class="form-check-input"><label for="Sick12Anticoagulant-2" class="form-check-label">抗凝血藥物</label></div><div class="form-check pe-3 checkbox_input_text choice-item other-choice"><input id="Sick12Other-2" name="sick12" type="checkbox" value="其他" class="form-check-input"><label for="Sick12Other-2" class="form-check-label flex-none">其他</label><input aria-label="其他補充說明" data-for="Sick12Other" id="Sick12OtherText-2" name="sick12_th" type="text" class="form-control border-0 border-bottom bg-transparent px-1 py-0 shadow-none checkbox_form_control"></div></div></div></div><div id="ikzz8k-2-3" class="call d-flex flex-column checkbox_father_config contact-group required-choice-group fit-check-table"><div id="iie2rp-2" class="contact-group-body"><div id="inz05g-2" class="title required contact-group-title question-title">3️⃣手術史 </div><div class="d-flex ms-3 flex-md-row flex-column four_button contact-options two-options"><div class="form-check choice-item"><input id="Sick123None-2" name="sick123" required="" type="radio" value="無" class="form-check-input"><label for="Sick123None-2" class="form-check-label">無</label></div><div class="form-check pe-3 checkbox_input_text choice-item other-choice"><input id="Sick123Has-2" name="sick123" type="radio" value="有" class="form-check-input"><label for="Sick123Has-2" class="form-check-label flex-none">有</label><input aria-label="有補充說明" data-for="Sick123Has" id="Sick123HasText-2" name="sick123_th" type="text" class="form-control border-0 border-bottom bg-transparent px-1 py-0 shadow-none checkbox_form_control"></div></div><div class="invalid-feedback">請選擇病史 </div></div></div><div id="inzg9h-2" class="call d-flex flex-column checkbox_father_config contact-group required-choice-group fit-check-table"><div id="i2kcch-2" class="contact-group-body"><div id="iq03fh-2" class="title required contact-group-title question-title">4️⃣住院史 </div><div class="d-flex ms-3 flex-md-row flex-column four_button contact-options two-options"><div class="form-check choice-item"><input id="Sick1234None-2-2" name="sick1234" required="" type="radio" value="無" class="form-check-input"><label for="Sick1234None-2-2" class="form-check-label">無</label></div><div class="form-check pe-3 checkbox_input_text choice-item other-choice"><input id="Sick1234Has-2-2" name="sick1234" type="radio" value="有" class="form-check-input"><label for="Sick1234Has-2-2" class="form-check-label flex-none">有</label><input aria-label="有補充說明" data-for="Sick1234Has" id="Sick1234HasText-2-2" name="sick1234_th" type="text" class="form-control border-0 border-bottom bg-transparent px-1 py-0 shadow-none checkbox_form_control"></div></div><div class="invalid-feedback">請選擇病史 </div></div></div><div id="im9ahe-2" class="call d-flex flex-column checkbox_father_config contact-group required-choice-group fit-check-table"><div id="il8e1e-2" class="contact-group-body"><div class="title required contact-group-title question-title">5️⃣藥物過敏 </div><div class="d-flex ms-3 flex-md-row flex-column four_button contact-options two-options"><div class="form-check choice-item"><input id="Sick12345None-2-2" name="sick12345" required="" type="radio" value="無" class="form-check-input"><label for="Sick12345None-2-2" class="form-check-label">無</label></div><div class="form-check pe-3 checkbox_input_text choice-item other-choice"><input id="Sick12345Has-2-2" name="sick12345" type="radio" value="有" class="form-check-input"><label for="Sick12345Has-2-2" class="form-check-label flex-none">有</label><input aria-label="有補充說明" data-for="Sick12345Has" id="Sick12345HasText-2-2" name="sick12345_th" type="text" class="form-control border-0 border-bottom bg-transparent px-1 py-0 shadow-none checkbox_form_control"></div></div><div class="invalid-feedback">請選擇是否藥物過敏 </div></div></div><div id="i7dlsy-2-3" class="call d-flex flex-column checkbox_father_config contact-group required-choice-group fit-check-table"><div id="i6y4ri-2-2" class="contact-group-body"><div class="title required contact-group-title question-title">6️⃣食物過敏 </div><div class="d-flex ms-3 flex-md-row flex-column four_button contact-options two-options"><div class="form-check choice-item"><input id="Sick61None-2-2" name="sick61" required="" type="radio" value="無" class="form-check-input"><label for="Sick61None-2-2" class="form-check-label">無</label></div><div class="form-check pe-3 checkbox_input_text choice-item other-choice"><input id="Sick61Has-2-2" name="sick61" type="radio" value="有" class="form-check-input"><label for="Sick61Has-2-2" class="form-check-label flex-none">有</label><input aria-label="有補充說明" data-for="Sick61Has" id="Sick61HasText-2-2" name="sick61_th" type="text" class="form-control border-0 border-bottom bg-transparent px-1 py-0 shadow-none checkbox_form_control"></div></div><div class="invalid-feedback">請選擇是否食物過敏 </div></div></div><div id="iqk0bb-2-2" class="contact-group-body compact-question-body"><div id="iibbpe-2-2" class="contact-field text-field required-field compact-text-field form-floating"><label for="InputHeight" id="ikgn4p" class="contact-label required question-title">7️⃣身高(cm)</label><input id="InputHeight-2-2" name="height" placeholder="" required="" type="text" class="form-control"><div class="invalid-feedback">請輸入身高 </div></div></div><div id="iv6p2x-2-2" data-key="" class="contact-group-body compact-question-body"><div id="i2aybe-2-2" data-key="" class="contact-field text-field required-field compact-text-field form-floating"><label id="icem2f-2-2" data-key="" class="contact-label required question-title">8️⃣體重(kg)</label><input id="InputWeight-2-2-2" name="weight" data-key="" placeholder="" required="" class="form-control"><div id="ilgji9-2-2" data-key="" class="invalid-feedback">請輸入體重 </div></div></div><div id="iag352-2-2" class="contact-group-body"><div id="iqx1qf-2-2" class="title required contact-group-title question-title">9️⃣飲食習慣 </div><div class="d-flex ms-3 flex-md-row flex-column four_button contact-options"><div id="i52b43-2-2" class="form-check choice-item"><input id="Sick62Meat-2-2" name="sick62" required="" type="radio" value="葷" class="form-check-input"><label for="Sick62Meat-2-2" class="form-check-label">葷</label></div><div class="form-check choice-item"><input id="Sick62Vegetarian-2-2" name="sick62" type="radio" value="素" class="form-check-input"><label for="Sick62Vegetarian-2-2" class="form-check-label">素</label></div><div class="form-check pe-3 checkbox_input_text choice-item other-choice"><input id="Sick62Other-2-2" name="sick62" type="radio" value="其他" class="form-check-input"><label for="Sick62Other-2-2" class="form-check-label flex-none">其他</label><input aria-label="其他補充說明" data-for="Sick62Other" id="Sick62OtherText-2-2" name="sick62_th" type="text" class="form-control border-0 border-bottom bg-transparent px-1 py-0 shadow-none checkbox_form_control"></div></div><div class="invalid-feedback">請輸入飲食習慣 </div></div></div></div><div class="contact-field textarea-field full-line has-placeholder form-floating"><label for="TextareaDescription" class="contact-label">其他說明事項</label><textarea id="TextareaDescription-2-2" name="description" placeholder="我們無法受理新進人員、勞工、供膳、保險、學生、收養、入住安養院或政府補助等體檢,此檢查請洽B1國人健檢03-3179599轉7121" class="form-control"></textarea></div><div id="Explanation-2-2" class="explanation-block"><div class="title required">隱私權及個人資料保護說明 </div><p custom_block_template="true" block_id="customBlockTemplate_70723" id="iurjsc-2" class="content border overflow-auto p-2 my-2 privacy-content"> 本網站尊重並保護您使用網際網路時的安全及隱私權,為了幫助您瞭解本網站如何蒐集、應用及保護您所提供的個人資訊,請您詳細閱讀下列資訊。 <br><br><b>一、關於政策適用範圍 </b><br>  本網站的隱私權政策,適用於您在使用本網站服務時,所涉及的個人資料蒐集、運用與保護,但不適用於與本網站連結之其他網站,凡經由本網站連結之網站均有其專屬之隱私權與資訊安全政策,本網站不負任何連帶責任,當您連結到這些網站時,關於個人資料的保護,適用各該網站的隱私權政策。 <br><br><b>二、關於個人資料蒐集的政策 </b><br><br><b>1、一般瀏覽與 Cookie 政策 </b><br>單純在本網站的瀏覽及檔案下載行為,本網站不會蒐集任何有關個人的身分資料。 <br>本網站會記錄使用者上站的 IP 位址、上網時間,以及在網站內所瀏覽的網頁等資料,這些資料係供本網站管理單位內部作網站流量和網路行為調查的總量分析,以利於提升本網站的服務品質,但並不會對個別使用者進行分析。 <br>本網站為提供良好之互動服務,會在本政策原則之下,在您的瀏覽器中寫入並讀取 cookies。本網站並不會利用 cookies 記錄任何個人隱私資料,也不會讀取其他網站寫入的任何 cookies。 <br><br><b>2、健檢預約服務之個人資料蒐集、處理、利用告知事項 </b><br>為提供您便捷的健康檢查預約服務,本網站將依據個人資料保護法(以下稱個資法)之規定,向您告知下列事項: <br><br><b>・蒐集之目的: </b><br>064 醫療、衛生保健及醫療照護。 <br>090 消費者、客戶管理與服務。 <br>157 調查、統計與研究分析。 <br><br><b>・蒐集之個人資料類別: </b><br>識別類:姓名、Email、聯絡電話、聯絡地址、身分證字號、出生年月日、公司名稱、服務單位、員工編號、職稱。 <br>特種個資與健康紀錄:個人健康狀況。 <br><br><b>・利用之期間、地區、對象及方式: </b><br>期間: 於上述蒐集目的之存續期間,或依相關法令(如醫療法、病歷保存規定)所定之保存年限。 <br>地區: 本網站服務所及之地區及醫療服務執行地。 <br>對象: 本網站管理單位、執行健檢之醫療機構/健檢中心。 <br>方式: 以數位檔案、紙本或電話等自動化或非自動化之方式進行處理與利用。 <br><br><b>3、您得行使之權利: </b> 依據個資法第 3 條規定,您就本網站所保有之個人資料得行使下列權利:查詢或請求閱覽、請求製給複製本、請求補充或更正、請求停止蒐集、處理或利用、請求刪除。您可以透過本網站提供之聯絡管道提出申請。 <br><br><b>4、不提供個人資料所致之權益影響: </b> 您得自由選擇是否提供上述個人資料,惟若您拒絕提供,或提供之資料不實、不完整,本網站將無法提供您線上預約健檢及後續相關之通知服務。 <br><br><b>三、關於與第三者共用個人資料的政策 </b><br>  本網站絕不會任意出售、交換或出租任何您個人資料給其他團體、個人或私人企業。但下列情形除外,本網站將依相關法令處理您的個人資料: <br>1、配合司法單位合法之調查,或相關職權機關依職務需要之調查或使用,本網站將視其適法性及是否遵照法定程序,採行可能必要的配合措施。 <br>2、當有人在本網站的行為,可能損害或妨礙本網站使用者或相關第三人之權益時,若本網站有理由相信揭露個人資料係為了辨識、聯絡或對該人採取法律行動所必要者,本網站得揭露使用者之個人資料。 <br><br><b>四、關於個人資料修改與維護的政策 </b><br>  本網站有義務保護各申請人隱私,非經您本人同意、主動申請,或符合以下法律及服務規範之一者,本網站不會自行修改、刪除任何個人資料及檔案: <br>1、配合司法機關或主管機關之合法調查與要求。 <br>2、為保護或防衛相關當事人、本網站或其他使用者之合法權益。 <br>3、使用者違反本網站使用條款或相關規定,本網站得依情節暫停、終止服務或依法處置相關資料。 <br><br><b>五、關於傳送宣傳資訊或電子郵件之政策 </b><br>1、本網站將在事前取得您的同意後,傳送宣傳本網站之資料或電子郵件給您。本網站會在該資料或電子郵件上提供您能隨時停止接收這些資料或電子郵件的方法、說明或功能連結。 <br>2、若您選擇拒絕接收此類宣傳資訊,本網站除依法令規定或為履行健檢預約服務之必要通知(如預約確認、檢查前注意事項、報告領取通知等)外,將停止對您發送行銷及宣傳內容。 </p><div class="form-check agree-check"><input id="CheckAgree-2-2" name="CheckAgree" required="" type="checkbox" value="" class="form-check-input"><label for="CheckAgree" class="form-check-label">我已閱讀並同意隱私權及個人資料保護說明</label><div class="invalid-feedback">請閱讀並同意隱私權及個人資料保護說明 </div></div></div><div id="Endline-2-2" class="row gx-0 align-items-end mt-2 mt-md-3 endline-row"><div class="captcha-field-col"><div class="captcha-field form-floating"><label for="InputCaptcha" class="required">驗證碼</label><input id="InputCaptcha-2-2" minlength="4" name="captcha" placeholder="輸入右側圖形驗證碼" required="" type="text" 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