form.main {
  width:945px; height:575px; margin:0px; background-image:url('images/background_text.jpg')}

form.erase {width:50px; height:1px; margin:0px}

input, textarea {
  font-family: verdana, arial, sans-serif; font-size: 9pt; color: #6C6E51 }

input.text {
  width:206px; height:19px; border:1px solid #737373; margin-top:3px; margin-right:3px }

label.text {float:left; width:70px; margin-top:5px}

textarea.two_lines {
  width:276px; height:34px; border:1px solid #737373; margin:0px; overflow:auto }

div.head {
  position:absolute; left:30px; top:10px; width:420px; height:50px; overflow:hidden }

div.subhead {
  position:absolute; left:445px; top:10px; width:471px; height:50px; overflow:hidden }

div.column_1 {
  position:absolute; left:30px; top:65px; width:299px; height:440px; overflow:auto}

  div.full_name     { position:absolute; left:0px; top:  0px; width:299px; height: 22px }
  div.furigana      { position:absolute; left:0px; top: 22px; width:299px; height: 22px }
  div.address_1     { position:absolute; left:0px; top: 44px; width:299px; height: 22px }
  div.address_2     { position:absolute; left:0px; top: 66px; width:299px; height: 22px }
  div.address_3     { position:absolute; left:0px; top: 88px; width:299px; height: 22px }
  div.telephone     { position:absolute; left:0px; top:110px; width:299px; height: 22px }
  div.fax           { position:absolute; left:0px; top:132px; width:299px; height: 22px }
  div.mobile        { position:absolute; left:0px; top:154px; width:299px; height: 22px }
  div.e_mail        { position:absolute; left:0px; top:176px; width:299px; height: 22px }
  div.occupation    { position:absolute; left:0px; top:198px; width:299px; height: 22px }
  div.birth_date    { position:absolute; left:0px; top:220px; width:299px; height: 22px }
  
  div.attend_before { position:absolute; left:0px; top:255px; width:299px; height: 40px }
  div.first_time    { position:absolute; left:0px; top:295px; width:299px; height: 20px }
  div.repeater      { position:absolute; left:0px; top:315px; width:299px; height: 20px }
  div.picture_1     { position:absolute; left:0px; top:349px; width:299px; height: 85px }

div.column_2 {
  position:absolute; left:335px; top:65px; width:299px; height:440px; overflow:auto }

  div.passive       { position:absolute; left:0px; top:  0px; width:299px; height: 20px }
  div.active        { position:absolute; left:0px; top: 20px; width:299px; height: 20px }
  div.issue         { position:absolute; left:0px; top: 42px; width:299px; height:160px }
  
  textarea.issue_case {
          width:276px; height:96px; border:1px solid #737373; margin:0px; overflow:auto }

  div.witnessed     { position:absolute; left:0px; top:235px; width:299px; height: 20px }
  div.done_before   { position:absolute; left:0px; top:275px; width:299px; height: 20px }
  div.therapy       { position:absolute; left:0px; top:295px; width:299px; height: 20px }
  div.doctor        { position:absolute; left:0px; top:335px; width:299px; height: 20px }
  div.clinic        { position:absolute; left:0px; top:375px; width:299px; height: 20px }
  div.medicine      { position:absolute; left:0px; top:395px; width:299px; height: 20px }
  div.which         { position:absolute; left:0px; top:412px; width:299px; height: 22px }

div.column_3 {
  position:absolute; left:640px; top:65px; width:299px; height:440px; overflow:auto }

  div.policy { position:absolute; left:0px; top:239px; width:274px; height:90px; 
    overflow:auto; border:1px solid #DDDDDD }
  
  div.find_out      { position:absolute; left:0px; top:140px; width:299px; height: 60px }
  div.acceptance    { position:absolute; left:0px; top:336px; width:299px; height: 20px }
  div.notification  { position:absolute; left:0px; top:376px; width:299px; height: 44px }

div.message_area {
  position:absolute; left:30px; top:510px; width:730px; height:60px;}

div.submission {
  position:absolute; left:854px; top:546px; width:70px; height:22px;}

div.erase {
  position:absolute; left:801px; top:546px; width:50px; height:22px;}

p {font-size:9pt; line-height:14px}
p.policy {font-size:8pt; line-height:14px}
li.policy {font-size:8pt; line-height:14px; margin-left:20px; margin-top:4px}