{"id":6155,"date":"2021-09-25T16:41:41","date_gmt":"2021-09-25T13:11:41","guid":{"rendered":"https:\/\/golsateb.com\/free-medical-advice\/"},"modified":"2021-12-29T10:49:07","modified_gmt":"2021-12-29T07:19:07","slug":"free-medical-advice","status":"publish","type":"page","link":"https:\/\/golsateb.com\/ar\/free-medical-advice\/","title":{"rendered":"\u0627\u0633\u062a\u0634\u0627\u0631\u0629 \u0637\u0628\u064a\u0629 \u0645\u062c\u0627\u0646\u064a\u0629"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"6155\" class=\"elementor elementor-6155 elementor-3523\" data-elementor-settings=\"[]\">\n\t\t\t\t\t\t<div class=\"elementor-inner\">\n\t\t\t\t\t\t\t<div class=\"elementor-section-wrap\">\n\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-fe60311 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"fe60311\" 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value='\u0627\u0628\u062d\u062b\u0648\u0627 \u0639\u0646 \u0627\u0644\u0637\u0628\u064a\u0628 \u0627\u0644\u0645\u062e\u062a\u0635 \u0627\u0644\u0645\u0637\u0644\u0648\u0628'  id='choice_3_4_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_4_3' id='label_3_4_3'>\u0627\u0628\u062d\u062b\u0648\u0627 \u0639\u0646 \u0627\u0644\u0637\u0628\u064a\u0628 \u0627\u0644\u0645\u062e\u062a\u0635 \u0627\u0644\u0645\u0637\u0644\u0648\u0628<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_3_4_4'>\n\t\t\t\t\t\t\t\t<input name='input_4.4' type='checkbox'  value='\u0627\u062d\u0635\u0644\u0648\u0627 \u0639\u0644\u0649 \u0645\u0639\u0644\u0648\u0645\u0627\u062a \u0639\u0627\u0645\u0629'  id='choice_3_4_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_4_4' id='label_3_4_4'>\u0627\u062d\u0635\u0644\u0648\u0627 \u0639\u0644\u0649 \u0645\u0639\u0644\u0648\u0645\u0627\u062a \u0639\u0627\u0645\u0629<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_3_4_5'>\n\t\t\t\t\t\t\t\t<input name='input_4.5' type='checkbox'  value='\u0627\u0644\u062a\u0639\u0631\u0641 \u0639\u0644\u06cc \u0627\u0644\u0623\u0633\u0639\u0627\u0631 \u0648 \u0627\u0644\u062a\u06a9\u0627\u0644\u06cc\u0641'  id='choice_3_4_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_4_5' id='label_3_4_5'>\u0627\u0644\u062a\u0639\u0631\u0641 \u0639\u0644\u06cc \u0627\u0644\u0623\u0633\u0639\u0627\u0631 \u0648 \u0627\u0644\u062a\u06a9\u0627\u0644\u06cc\u0641<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer'>\n                         <input type='button' id='gform_next_button_3_3' class='gform_next_button button' value='\u0627\u0644\u062e\u0637\u0648\u0629 \u0627\u0644\u062a\u0627\u0644\u064a\u0629'  onclick='jQuery(\"#gform_target_page_number_3\").val(\"2\");  jQuery(\"#gform_3\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_3\").val(\"2\");  jQuery(\"#gform_3\").trigger(\"submit\",[true]); } ' \/> 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gfield_visibility_visible' ><label class='gfield_label' for='input_3_7' >\u0623\u0646\u062a\u0645 \u0645\u0646 \u0623\u064a \u0628\u0644\u062f\u061f<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_7' id='input_3_7' class='medium gfield_select'   aria-required=\"true\" aria-invalid=\"false\"><option value='\u0623\u0630\u0631\u0628\u064a\u062c\u0627\u0646' >\u0623\u0630\u0631\u0628\u064a\u062c\u0627\u0646<\/option><option value='\u0627\u0644\u0623\u0631\u062c\u0646\u062a\u064a\u0646' >\u0627\u0644\u0623\u0631\u062c\u0646\u062a\u064a\u0646<\/option><option value='\u062c\u0646\u0648\u0628 \u0623\u0641\u0631\u064a\u0642\u064a\u0627' >\u062c\u0646\u0648\u0628 \u0623\u0641\u0631\u064a\u0642\u064a\u0627<\/option><option value='\u0627\u0641\u0631\u064a\u0642\u064a\u0627 \u0627\u0644\u0648\u0633\u0637\u0649' >\u0627\u0641\u0631\u064a\u0642\u064a\u0627 \u0627\u0644\u0648\u0633\u0637\u0649<\/option><option value='\u0623\u0644\u0628\u0627\u0646\u064a\u0627' >\u0623\u0644\u0628\u0627\u0646\u064a\u0627<\/option><option value='\u0623\u0644\u0645\u0627\u0646\u064a\u0627' >\u0623\u0644\u0645\u0627\u0646\u064a\u0627<\/option><option value='\u0623\u0646\u062a\u064a\u063a\u0648\u0627\u0648\u0628\u0627\u0631\u0628\u0648\u062f\u0627' >\u0623\u0646\u062a\u064a\u063a\u0648\u0627\u0648\u0628\u0627\u0631\u0628\u0648\u062f\u0627<\/option><option value='\u0623\u0646\u062f\u0648\u0631\u0627' >\u0623\u0646\u062f\u0648\u0631\u0627<\/option><option value='\u0623\u0646\u063a\u0648\u0644\u0627' >\u0623\u0646\u063a\u0648\u0644\u0627<\/option><option value='\u0627\u0644\u0646\u0645\u0633\u0627' >\u0627\u0644\u0646\u0645\u0633\u0627<\/option><option value='\u0623\u062b\u064a\u0648\u0628\u064a\u0627' >\u0623\u062b\u064a\u0648\u0628\u064a\u0627<\/option><option value='\u0627\u0644\u0623\u0631\u062f\u0646' >\u0627\u0644\u0623\u0631\u062f\u0646<\/option><option value='\u0623\u0631\u0645\u064a\u0646\u064a\u0627' >\u0623\u0631\u0645\u064a\u0646\u064a\u0627<\/option><option value='\u0625\u0631\u064a\u062a\u0631\u064a\u0627' >\u0625\u0631\u064a\u062a\u0631\u064a\u0627<\/option><option value='\u0623\u0648\u0632\u0628\u0643\u0633\u062a\u0627\u0646' >\u0623\u0648\u0632\u0628\u0643\u0633\u062a\u0627\u0646<\/option><option value='\u0625\u0633\u0628\u0627\u0646\u064a\u0627' >\u0625\u0633\u0628\u0627\u0646\u064a\u0627<\/option><option value='\u0623\u0633\u062a\u0631\u0627\u0644\u064a\u0627' >\u0623\u0633\u062a\u0631\u0627\u0644\u064a\u0627<\/option><option value='\u0625\u0633\u062a\u0648\u0646\u064a\u0627' >\u0625\u0633\u062a\u0648\u0646\u064a\u0627<\/option><option value='\u0633\u0644\u0648\u0641\u0627\u0643\u064a\u0627' >\u0633\u0644\u0648\u0641\u0627\u0643\u064a\u0627<\/option><option value='\u0633\u0644\u0648\u0641\u064a\u0646\u064a\u0627' >\u0633\u0644\u0648\u0641\u064a\u0646\u064a\u0627<\/option><option value='\u0623\u0641\u063a\u0627\u0646\u0633\u062a\u0627\u0646' >\u0623\u0641\u063a\u0627\u0646\u0633\u062a\u0627\u0646<\/option><option value='\u0627\u0644\u0627\u0643\u0648\u0627\u062f\u0648\u0631' >\u0627\u0644\u0627\u0643\u0648\u0627\u062f\u0648\u0631<\/option><option value='\u0627\u0644\u062c\u0632\u0627\u0626\u0631' >\u0627\u0644\u062c\u0632\u0627\u0626\u0631<\/option><option value='\u0627\u0644\u0633\u0644\u0641\u0627\u062f\u0648\u0631' >\u0627\u0644\u0633\u0644\u0641\u0627\u062f\u0648\u0631<\/option><option value='\u0627\u0644\u0625\u0645\u0627\u0631\u0627\u062a \u0627\u0644\u0639\u0631\u0628\u064a\u0629 \u0627\u0644\u0645\u062a\u062d\u062f\u0629' >\u0627\u0644\u0625\u0645\u0627\u0631\u0627\u062a \u0627\u0644\u0639\u0631\u0628\u064a\u0629 \u0627\u0644\u0645\u062a\u062d\u062f\u0629<\/option><option value='\u0623\u0645\u0631\u064a\u0643\u0627' >\u0623\u0645\u0631\u064a\u0643\u0627<\/option><option value='\u0625\u0646\u062f\u0648\u0646\u064a\u0633\u064a\u0627' >\u0625\u0646\u062f\u0648\u0646\u064a\u0633\u064a\u0627<\/option><option value='\u0625\u0646\u0643\u0644\u062a\u0631\u0627' >\u0625\u0646\u0643\u0644\u062a\u0631\u0627<\/option><option value='\u0623\u0648\u0631\u0648\u063a\u0648\u0627\u064a' >\u0623\u0648\u0631\u0648\u063a\u0648\u0627\u064a<\/option><option value='\u0623\u0648\u0643\u0631\u0627\u0646\u064a\u0627' >\u0623\u0648\u0643\u0631\u0627\u0646\u064a\u0627<\/option><option value='\u0623\u0648\u063a\u0646\u062f\u0627' >\u0623\u0648\u063a\u0646\u062f\u0627<\/option><option value='\u0625\u064a\u0637\u0627\u0644\u064a\u0627' >\u0625\u064a\u0637\u0627\u0644\u064a\u0627<\/option><option value='\u0627\u06cc\u0631\u0627\u0646' >\u0627\u06cc\u0631\u0627\u0646<\/option><option value='\u0623\u064a\u0631\u0644\u0646\u062f\u0627' >\u0623\u064a\u0631\u0644\u0646\u062f\u0627<\/option><option value='\u0623\u064a\u0633\u0644\u0646\u062f\u0627' >\u0623\u064a\u0633\u0644\u0646\u062f\u0627<\/option><option value='\u0628\u0631\u0628\u0627\u062f\u0648\u0633' >\u0628\u0631\u0628\u0627\u062f\u0648\u0633<\/option><option value='\u062c\u0632\u0631 \u0627\u0644\u0628\u0647\u0627\u0645\u0627' >\u062c\u0632\u0631 \u0627\u0644\u0628\u0647\u0627\u0645\u0627<\/option><option value='\u0627\u0644\u0628\u062d\u0631\u064a\u0646' >\u0627\u0644\u0628\u062d\u0631\u064a\u0646<\/option><option value='\u0627\u0644\u0628\u0631\u0627\u0632\u064a\u0644' >\u0627\u0644\u0628\u0631\u0627\u0632\u064a\u0644<\/option><option value='\u0628\u0631\u0648\u0646\u0627\u064a' >\u0628\u0631\u0648\u0646\u0627\u064a<\/option><option value='\u0628\u0631\u064a\u0637\u0627\u0646\u064a\u0627' >\u0628\u0631\u064a\u0637\u0627\u0646\u064a\u0627<\/option><option value='\u0628\u064a\u0644\u0627\u0631\u0648\u0633\u064a\u0627' >\u0628\u064a\u0644\u0627\u0631\u0648\u0633\u064a\u0627<\/option><option value='\u0628\u0644\u062c\u064a\u0643\u0627' >\u0628\u0644\u062c\u064a\u0643\u0627<\/option><option value='\u0628\u0644\u063a\u0627\u0631\u064a\u0627' >\u0628\u0644\u063a\u0627\u0631\u064a\u0627<\/option><option value='\u0628\u0646\u063a\u0644\u0627\u062f\u064a\u0634' >\u0628\u0646\u063a\u0644\u0627\u062f\u064a\u0634<\/option><option value='\u0628\u0646\u064a\u0646' >\u0628\u0646\u064a\u0646<\/option><option value='\u0628\u0648\u062a\u0627\u0646' >\u0628\u0648\u062a\u0627\u0646<\/option><option value='\u0628\u0648\u062a\u0633\u0648\u0627\u0646\u0627' >\u0628\u0648\u062a\u0633\u0648\u0627\u0646\u0627<\/option><option value='\u0628\u0648\u0631\u06a9\u06cc\u0646\u0627\u0641\u0627\u0633\u0648' >\u0628\u0648\u0631\u06a9\u06cc\u0646\u0627\u0641\u0627\u0633\u0648<\/option><option value='\u0628\u0648\u0631\u0648\u0646\u062f\u064a' >\u0628\u0648\u0631\u0648\u0646\u062f\u064a<\/option><option value='\u0628\u0648\u0644\u064a\u0641\u064a\u0627' >\u0628\u0648\u0644\u064a\u0641\u064a\u0627<\/option><option value='\u0628\u0627\u0628\u0648\u0627 \u063a\u064a\u0646\u064a\u0627 \u0627\u0644\u062c\u062f\u064a\u062f\u0629' >\u0628\u0627\u0628\u0648\u0627 \u063a\u064a\u0646\u064a\u0627 \u0627\u0644\u062c\u062f\u064a\u062f\u0629<\/option><option value='\u0628\u0627\u0631\u0627\u063a\u0648\u0627\u064a' >\u0628\u0627\u0631\u0627\u063a\u0648\u0627\u064a<\/option><option value='\u0628\u0627\u0643\u0633\u062a\u0627\u0646' >\u0628\u0627\u0643\u0633\u062a\u0627\u0646<\/option><option value='\u0628\u0646\u0645\u0627' >\u0628\u0646\u0645\u0627<\/option><option value='\u0627\u0644\u0628\u0631\u062a\u063a\u0627\u0644' >\u0627\u0644\u0628\u0631\u062a\u063a\u0627\u0644<\/option><option value='\u0628\u064a\u0631\u0648' >\u0628\u064a\u0631\u0648<\/option><option value='\u0637\u0627\u062c\u064a\u0643\u0633\u062a\u0627\u0646' >\u0637\u0627\u062c\u064a\u0643\u0633\u062a\u0627\u0646<\/option><option value='\u062a\u0646\u0632\u0627\u0646\u064a\u0627' >\u062a\u0646\u0632\u0627\u0646\u064a\u0627<\/option><option value='\u062a\u0627\u064a\u0644\u0627\u0646\u062f' >\u062a\u0627\u064a\u0644\u0627\u0646\u062f<\/option><option value='\u062a\u0631\u0643\u0645\u0627\u0646\u0633\u062a\u0627\u0646' >\u062a\u0631\u0643\u0645\u0627\u0646\u0633\u062a\u0627\u0646<\/option><option value='\u062a\u0631\u06a9\u06cc\u0627' >\u062a\u0631\u06a9\u06cc\u0627<\/option><option value='\u062a\u0631\u064a\u0646\u062f\u0627\u062f \u0648\u062a\u0648\u0628\u0627\u063a\u0648' >\u062a\u0631\u064a\u0646\u062f\u0627\u062f \u0648\u062a\u0648\u0628\u0627\u063a\u0648<\/option><option value='\u062a\u0648\u062c\u0648' >\u062a\u0648\u062c\u0648<\/option><option value='\u062a\u0648\u0646\u0633' >\u062a\u0648\u0646\u0633<\/option><option value='\u062a\u0648\u0646\u06af\u0627' >\u062a\u0648\u0646\u06af\u0627<\/option><option value='\u062a\u0648\u0648\u0627\u0644\u0648' >\u062a\u0648\u0648\u0627\u0644\u0648<\/option><option value='\u062c\u0627\u0645\u0627\u064a\u0643\u0627' >\u062c\u0627\u0645\u0627\u064a\u0643\u0627<\/option><option value='\u062c\u064a\u0628\u0648\u062a\u064a' >\u062c\u064a\u0628\u0648\u062a\u064a<\/option><option value='\u062a\u0634\u0627\u062f' >\u062a\u0634\u0627\u062f<\/option><option value='\u0627\u0644\u062a\u0634\u064a\u0643\u064a\u0629' >\u0627\u0644\u062a\u0634\u064a\u0643\u064a\u0629<\/option><option value='\u0627\u0644\u0635\u064a\u0646' >\u0627\u0644\u0635\u064a\u0646<\/option><option value='\u062a\u0627\u064a\u0628\u064a\u0647 \u0627\u0644\u0635\u064a\u0646\u064a\u0629' >\u062a\u0627\u064a\u0628\u064a\u0647 \u0627\u0644\u0635\u064a\u0646\u064a\u0629<\/option><option value='\u0627\u0644\u062f\u0646\u0645\u0627\u0631\u0643' >\u0627\u0644\u062f\u0646\u0645\u0627\u0631\u0643<\/option><option value='\u062f\u0648\u0645\u064a\u0646\u064a\u0643\u0627' >\u062f\u0648\u0645\u064a\u0646\u064a\u0643\u0627<\/option><option value='\u062f\u0648\u0645\u06cc\u0646\u06a9\u0646' >\u062f\u0648\u0645\u06cc\u0646\u06a9\u0646<\/option><option value='\u0631\u0648\u0622\u0646\u062f\u0627' >\u0631\u0648\u0622\u0646\u062f\u0627<\/option><option value='\u0631\u0648\u0633\u06cc\u0627' >\u0631\u0648\u0633\u06cc\u0627<\/option><option value='\u0631\u0648\u0645\u0627\u0646\u064a\u0627' >\u0631\u0648\u0645\u0627\u0646\u064a\u0627<\/option><option value='\u0632\u0627\u0626\u064a\u0631' >\u0632\u0627\u0626\u064a\u0631<\/option><option value='\u0632\u0627\u0645\u0628\u06cc\u0627' >\u0632\u0627\u0645\u0628\u06cc\u0627<\/option><option value='\u0646\u064a\u0648\u0632\u064a\u0644\u0646\u062f\u0627' >\u0646\u064a\u0648\u0632\u064a\u0644\u0646\u062f\u0627<\/option><option value='\u0632\u06cc\u0645\u0628\u0627\u0648\u0647' >\u0632\u06cc\u0645\u0628\u0627\u0648\u0647<\/option><option value='\u0627\u0644\u064a\u0627\u0628\u0627\u0646' >\u0627\u0644\u064a\u0627\u0628\u0627\u0646<\/option><option value='\u0633\u0627\u0648 \u062a\u0648\u0645\u064a \u0648\u0628\u0631\u064a\u0646\u0633\u064a\u0628\u064a' >\u0633\u0627\u0648 \u062a\u0648\u0645\u064a \u0648\u0628\u0631\u064a\u0646\u0633\u064a\u0628\u064a<\/option><option value='\u0633\u0627\u062d\u0644 \u0627\u0644\u0639\u0627\u062c' >\u0633\u0627\u062d\u0644 \u0627\u0644\u0639\u0627\u062c<\/option><option value='\u0633\u0627\u0645\u0648\u0627 \u0627\u0644\u063a\u0631\u0628\u064a\u0629' >\u0633\u0627\u0645\u0648\u0627 \u0627\u0644\u063a\u0631\u0628\u064a\u0629<\/option><option value='\u0633\u0627\u0646 \u0645\u0627\u0631\u064a\u0646\u0648' >\u0633\u0627\u0646 \u0645\u0627\u0631\u064a\u0646\u0648<\/option><option value='\u0633\u064a\u0631\u064a\u0644\u0627\u0646\u0643\u0627' >\u0633\u064a\u0631\u064a\u0644\u0627\u0646\u0643\u0627<\/option><option value='\u0633\u0644\u06cc\u0645\u0627\u0646\u0647' >\u0633\u0644\u06cc\u0645\u0627\u0646\u0647<\/option><option value='\u0633\u0627\u0646\u062a \u0643\u0631\u064a\u0633\u062a\u0648\u0641\u0631 \u0641\u064a\u0646\u0648\u0633' >\u0633\u0627\u0646\u062a \u0643\u0631\u064a\u0633\u062a\u0648\u0641\u0631 \u0641\u064a\u0646\u0648\u0633<\/option><option value='\u0633\u0627\u0646\u062a \u0644\u0648\u0633\u064a\u0627' >\u0633\u0627\u0646\u062a \u0644\u0648\u0633\u064a\u0627<\/option><option value='\u0633\u0627\u0646\u062a \u0641\u0646\u0633\u0646\u062a \u0648\u062c\u0632\u0631 \u063a\u0631\u064a\u0646\u0627\u062f\u064a\u0646' >\u0633\u0627\u0646\u062a \u0641\u0646\u0633\u0646\u062a \u0648\u062c\u0632\u0631 \u063a\u0631\u064a\u0646\u0627\u062f\u064a\u0646<\/option><option value='\u0633\u0646\u063a\u0627\u0641\u0648\u0631\u0629' >\u0633\u0646\u063a\u0627\u0641\u0648\u0631\u0629<\/option><option value='\u0627\u0644\u0633\u0646\u063a\u0627\u0644' >\u0627\u0644\u0633\u0646\u063a\u0627\u0644<\/option><option value='\u0633\u0648\u0627\u0632\u064a\u0644\u0627\u0646\u062f' >\u0633\u0648\u0627\u0632\u064a\u0644\u0627\u0646\u062f<\/option><option value='\u0627\u0644\u0633\u0648\u064a\u062f' >\u0627\u0644\u0633\u0648\u064a\u062f<\/option><option value='\u0627\u0644\u0633\u0648\u062f\u0627\u0646' >\u0627\u0644\u0633\u0648\u062f\u0627\u0646<\/option><option value='\u0633\u0648\u0631\u06cc\u0646\u0627\u0645' >\u0633\u0648\u0631\u06cc\u0646\u0627\u0645<\/option><option value='\u0633\u0648\u0631\u06cc\u0627' >\u0633\u0648\u0631\u06cc\u0627<\/option><option value='\u0635\u0648\u0645\u0627\u0644\u064a' >\u0635\u0648\u0645\u0627\u0644\u064a<\/option><option value='\u0633\u0648\u064a\u0633\u0631\u064a' >\u0633\u0648\u064a\u0633\u0631\u064a<\/option><option value='\u0633\u064a\u0631\u0627\u0644\u064a\u0648\u0646' >\u0633\u064a\u0631\u0627\u0644\u064a\u0648\u0646<\/option><option value='\u0633\u06cc\u0634\u06cc\u0644' >\u0633\u06cc\u0634\u06cc\u0644<\/option><option value='\u062a\u0634\u064a\u0644\u064a' >\u062a\u0634\u064a\u0644\u064a<\/option><option value='\u0635\u0631\u0628\u064a\u0627' >\u0635\u0631\u0628\u064a\u0627<\/option><option value='\u0627\u0644\u0639\u0631\u0627\u0642' >\u0627\u0644\u0639\u0631\u0627\u0642<\/option><option value='\u0627\u0644\u0645\u0645\u0644\u0643\u0629 \u0627\u0644\u0639\u0631\u0628\u064a\u0629 \u0627\u0644\u0633\u0639\u0648\u062f\u064a\u0629' >\u0627\u0644\u0645\u0645\u0644\u0643\u0629 \u0627\u0644\u0639\u0631\u0628\u064a\u0629 \u0627\u0644\u0633\u0639\u0648\u062f\u064a\u0629<\/option><option value='\u0633\u0644\u0637\u0646\u0629 \u0639\u0645\u0627\u0646' >\u0633\u0644\u0637\u0646\u0629 \u0639\u0645\u0627\u0646<\/option><option value='\u063a\u0646\u0627' >\u063a\u0646\u0627<\/option><option value='\u0641\u0631\u0646\u0633\u0627' >\u0641\u0631\u0646\u0633\u0627<\/option><option value='\u0641\u0646\u0644\u0646\u062f\u0627' >\u0641\u0646\u0644\u0646\u062f\u0627<\/option><option value='\u0641\u064a\u062c\u064a' >\u0641\u064a\u062c\u064a<\/option><option value='\u0641\u064a\u0644\u0628\u064a\u0646\u064a' >\u0641\u064a\u0644\u0628\u064a\u0646\u064a<\/option><option value='\u0642\u0628\u0631\u0635' >\u0642\u0628\u0631\u0635<\/option><option value='\u0642\u064a\u0631\u063a\u064a\u0632\u0633\u062a\u0627\u0646' >\u0642\u064a\u0631\u063a\u064a\u0632\u0633\u062a\u0627\u0646<\/option><option value='\u0643\u0627\u0632\u0627\u062e\u0633\u062a\u0627\u0646' >\u0643\u0627\u0632\u0627\u062e\u0633\u062a\u0627\u0646<\/option><option value='\u0642\u0637\u0631' >\u0642\u0637\u0631<\/option><option value='\u0643\u0645\u0628\u0648\u062f\u064a\u0627' >\u0643\u0645\u0628\u0648\u062f\u064a\u0627<\/option><option value='\u0643\u0627\u0645\u064a\u0631\u0648\u0646' >\u0643\u0627\u0645\u064a\u0631\u0648\u0646<\/option><option value='\u0643\u0646\u062f\u0627' >\u0643\u0646\u062f\u0627<\/option><option value='\u0643\u0631\u0648\u0627\u062a\u064a\u0627' >\u0643\u0631\u0648\u0627\u062a\u064a\u0627<\/option><option value='\u0643\u0648\u0631\u064a\u0627 \u0627\u0644\u062c\u0646\u0648\u0628\u064a\u0629' >\u0643\u0648\u0631\u064a\u0627 \u0627\u0644\u062c\u0646\u0648\u0628\u064a\u0629<\/option><option value='\u0643\u0648\u0631\u064a\u0627 \u0627\u0644\u0634\u0645\u0627\u0644\u064a\u0629' >\u0643\u0648\u0631\u064a\u0627 \u0627\u0644\u0634\u0645\u0627\u0644\u064a\u0629<\/option><option value='\u0643\u0648\u0633\u062a\u0627\u0631\u064a\u0643\u0627' >\u0643\u0648\u0633\u062a\u0627\u0631\u064a\u0643\u0627<\/option><option value='\u0643\u0648\u0644\u0648\u0645\u0628\u064a\u0627' >\u0643\u0648\u0644\u0648\u0645\u0628\u064a\u0627<\/option><option value='\u0627\u0644\u0643\u0648\u0646\u063a\u0648' >\u0627\u0644\u0643\u0648\u0646\u063a\u0648<\/option><option value='\u0643\u064a\u0646\u064a\u0627' >\u0643\u064a\u0646\u064a\u0627<\/option><option value='\u06a9\u0648\u0628\u0627' >\u06a9\u0648\u0628\u0627<\/option><option value='\u0643\u0648\u062a \u062f\u064a\u0641\u0648\u0627\u0631' >\u0643\u0648\u062a \u062f\u064a\u0641\u0648\u0627\u0631<\/option><option value='\u06a9\u0648\u0645\u0648\u0631' >\u06a9\u0648\u0645\u0648\u0631<\/option><option value='\u0627\u0644\u0643\u0648\u064a\u062a' >\u0627\u0644\u0643\u0648\u064a\u062a<\/option><option value='\u0627\u0644\u0631\u0623\u0633 \u0627\u0644\u0623\u062e\u0636\u0631' >\u0627\u0644\u0631\u0623\u0633 \u0627\u0644\u0623\u062e\u0636\u0631<\/option><option value='\u06a9\u06cc\u0631\u06cc\u0628\u0627\u0633' >\u06a9\u06cc\u0631\u06cc\u0628\u0627\u0633<\/option><option value='\u0627\u0644\u062c\u0627\u0628\u0648\u0646' >\u0627\u0644\u062c\u0627\u0628\u0648\u0646<\/option><option value='\u063a\u0627\u0645\u0628\u064a\u0627' >\u063a\u0627\u0645\u0628\u064a\u0627<\/option><option value='\u063a\u0631\u0646\u0627\u0637\u0629' >\u063a\u0631\u0646\u0627\u0637\u0629<\/option><option value='\u062c\u0648\u0631\u062c\u064a\u0627' >\u062c\u0648\u0631\u062c\u064a\u0627<\/option><option value='\u063a\u0648\u0627\u062a\u064a\u0645\u0627\u0644\u0627' >\u063a\u0648\u0627\u062a\u064a\u0645\u0627\u0644\u0627<\/option><option value='\u06af\u0648\u06cc\u0627\u0646' >\u06af\u0648\u06cc\u0627\u0646<\/option><option value='\u063a\u064a\u0646\u064a\u0627' >\u063a\u064a\u0646\u064a\u0627<\/option><option value='\u063a\u064a\u0646\u064a\u0627 \u0627\u0644\u0625\u0633\u062a\u0648\u0627\u0626\u064a\u0629' >\u063a\u064a\u0646\u064a\u0627 \u0627\u0644\u0625\u0633\u062a\u0648\u0627\u0626\u064a\u0629<\/option><option value='\u063a\u064a\u0646\u064a\u0627 \u0628\u064a\u0633\u0627\u0648' >\u063a\u064a\u0646\u064a\u0627 \u0628\u064a\u0633\u0627\u0648<\/option><option value='\u0644\u0627\u0648\u0633' >\u0644\u0627\u0648\u0633<\/option><option value='\u0644\u0627\u062a\u0641\u064a\u0627' >\u0644\u0627\u062a\u0641\u064a\u0627<\/option><option value='\u0644\u0628\u0646\u0627\u0646' >\u0644\u0628\u0646\u0627\u0646<\/option><option value='\u0644\u0633\u0648\u062a\u0648' >\u0644\u0633\u0648\u062a\u0648<\/option><option value='\u0645\u0627\u0633\u0648\u0641\u064a\u0646\u0627' >\u0645\u0627\u0633\u0648\u0641\u064a\u0646\u0627<\/option><option value='\u0645\u062f\u063a\u0634\u0642\u0631' >\u0645\u062f\u063a\u0634\u0642\u0631<\/option><option value='\u0645\u0644\u0627\u0648\u064a' >\u0645\u0644\u0627\u0648\u064a<\/option><option value='\u0645\u0627\u0644\u064a\u0632\u064a\u0627' >\u0645\u0627\u0644\u064a\u0632\u064a\u0627<\/option><option value='\u062c\u0632\u0631 \u0627\u0644\u0645\u0627\u0644\u062f\u064a\u0641' >\u062c\u0632\u0631 \u0627\u0644\u0645\u0627\u0644\u062f\u064a\u0641<\/option><option value='\u0645\u0627\u0644\u064a' >\u0645\u0627\u0644\u064a<\/option><option value='\u0645\u0627\u0644\u0637\u0627' >\u0645\u0627\u0644\u0637\u0627<\/option><option value='\u062c\u0632\u0631 \u0645\u0627\u0631\u0634\u0627\u0644' >\u062c\u0632\u0631 \u0645\u0627\u0631\u0634\u0627\u0644<\/option><option value='\u0645\u0648\u0631\u064a\u062a\u0627\u0646\u064a\u0627' >\u0645\u0648\u0631\u064a\u062a\u0627\u0646\u064a\u0627<\/option><option value='\u0645\u0627\u0631\u06cc\u062a\u06cc\u0648\u0633' >\u0645\u0627\u0631\u06cc\u062a\u06cc\u0648\u0633<\/option><option value='\u0627\u0644\u0645\u0643\u0633\u064a\u0643' >\u0627\u0644\u0645\u0643\u0633\u064a\u0643<\/option><option value='\u0648\u0644\u0627\u064a\u0627\u062a \u0645\u064a\u0643\u0631\u0648\u0646\u064a\u0632\u064a\u0627 \u0627\u0644\u0645\u0648\u062d\u062f\u0629' >\u0648\u0644\u0627\u064a\u0627\u062a \u0645\u064a\u0643\u0631\u0648\u0646\u064a\u0632\u064a\u0627 \u0627\u0644\u0645\u0648\u062d\u062f\u0629<\/option><option value='\u0645\u0648\u0644\u062f\u0648\u0641\u0627' >\u0645\u0648\u0644\u062f\u0648\u0641\u0627<\/option><option value='\u0645\u0648\u0646\u0627\u06a9\u0648' >\u0645\u0648\u0646\u0627\u06a9\u0648<\/option><option value='\u0645\u0648\u0646\u062c\u064a\u0644' >\u0645\u0648\u0646\u062c\u064a\u0644<\/option><option value='\u0627\u0644\u062c\u0628\u0644 \u0627\u0644\u0623\u0633\u0648\u062f' >\u0627\u0644\u062c\u0628\u0644 \u0627\u0644\u0623\u0633\u0648\u062f<\/option><option value='\u0627\u0644\u0645\u063a\u0631\u0628' >\u0627\u0644\u0645\u063a\u0631\u0628<\/option><option value='\u0645\u0648\u0632\u0645\u0628\u064a\u0642' >\u0645\u0648\u0632\u0645\u0628\u064a\u0642<\/option><option value='\u0645\u06cc\u0627\u0646\u0645\u0627\u0631' >\u0645\u06cc\u0627\u0646\u0645\u0627\u0631<\/option><option value='\u0647\u0646\u063a\u0627\u0631\u064a\u0627' >\u0647\u0646\u063a\u0627\u0631\u064a\u0627<\/option><option value='\u0645\u0635\u0631' >\u0645\u0635\u0631<\/option><option value='\u0646\u0627\u0645\u06cc\u0628\u06cc\u0627' >\u0646\u0627\u0645\u06cc\u0628\u06cc\u0627<\/option><option value='\u0646\u0627\u0631\u0648' >\u0646\u0627\u0631\u0648<\/option><option value='\u0646\u064a\u0628\u0627\u0644' >\u0646\u064a\u0628\u0627\u0644<\/option><option value='\u0646\u064a\u0648\u0632\u064a\u0644\u0646\u062f\u0627' >\u0646\u064a\u0648\u0632\u064a\u0644\u0646\u062f\u0627<\/option><option value='\u0646\u064a\u0643\u0627\u0631\u0627\u063a\u0648\u0627' >\u0646\u064a\u0643\u0627\u0631\u0627\u063a\u0648\u0627<\/option><option value='\u0627\u0644\u0646\u064a\u062c\u0631' >\u0627\u0644\u0646\u064a\u062c\u0631<\/option><option value='\u0646\u064a\u062c\u064a\u0631\u064a\u0627' >\u0646\u064a\u062c\u064a\u0631\u064a\u0627<\/option><option value='\u0648\u0627\u0646\u0648\u0622\u062a\u0648' >\u0648\u0627\u0646\u0648\u0622\u062a\u0648<\/option><option value='\u0627\u0644\u0641\u0627\u062a\u064a\u0643\u0627\u0646' >\u0627\u0644\u0641\u0627\u062a\u064a\u0643\u0627\u0646<\/option><option value='\u0641\u0646\u0632\u0648\u064a\u0644\u0627' >\u0641\u0646\u0632\u0648\u064a\u0644\u0627<\/option><option value='\u0641\u064a\u062a\u0646\u0627\u0645' >\u0641\u064a\u062a\u0646\u0627\u0645<\/option><option value='\u0627\u0644\u0647\u0646\u062f' >\u0627\u0644\u0647\u0646\u062f<\/option><option value='\u0647\u0646\u062f\u0648\u0631\u0627\u0633' >\u0647\u0646\u062f\u0648\u0631\u0627\u0633<\/option><option value='\u0647\u0648\u0644\u0646\u062f\u0627' >\u0647\u0648\u0644\u0646\u062f\u0627<\/option><option value='\u0627\u0644\u064a\u0645\u0646' >\u0627\u0644\u064a\u0645\u0646<\/option><option value='\u0627\u0644\u064a\u0648\u0646\u0627\u0646' >\u0627\u0644\u064a\u0648\u0646\u0627\u0646<\/option><option value='\u064a\u0648\u063a\u0648\u0633\u0644\u0627\u0641\u064a\u0627' >\u064a\u0648\u063a\u0648\u0633\u0644\u0627\u0641\u064a\u0627<\/option><option value='\u0622\u062e\u0631' >\u0622\u062e\u0631<\/option><\/select><\/div><\/li><li id='field_3_8'  class='gfield gf_right_half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_3_8' >\u0627\u0644\u062f\u0648\u0644\u0629 \u0627\u0644\u062a\u064a \u062a\u0642\u062f\u0645 \u0627\u0644\u062e\u062f\u0645\u0627\u062a<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_8' id='input_3_8' class='medium gfield_select'   aria-required=\"true\" aria-invalid=\"false\"><option value='\u0627\u06cc\u0631\u0627\u0646' >\u0627\u06cc\u0631\u0627\u0646<\/option><\/select><\/div><\/li><li id='field_3_9'  class='gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_3_9' >\u0627\u0644\u0645\u062f\u06cc\u0646\u0629 \u0627\u0644\u062a\u064a \u062a\u0642\u062f\u0645 \u0627\u0644\u062e\u062f\u0645\u0627\u062a<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_9' id='input_3_9' class='medium gfield_select'   aria-required=\"true\" aria-invalid=\"false\"><option value='\u062a\u0647\u0631\u0627\u0646' >\u062a\u0647\u0631\u0627\u0646<\/option><option value='\u0645\u0634\u0647\u062f' >\u0645\u0634\u0647\u062f<\/option><option value='\u0634\u06cc\u0631\u0627\u0632' >\u0634\u06cc\u0631\u0627\u0632<\/option><option value='\u062a\u0628\u0631\u06cc\u0632' >\u062a\u0628\u0631\u06cc\u0632<\/option><option value='\u0623\u0635\u0641\u0647\u0627\u0646' >\u0623\u0635\u0641\u0647\u0627\u0646<\/option><\/select><\/div><\/li><li id='field_3_10'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_3_10' >\u0645\u062a\u0649 \u0633\u062a\u0633\u0627\u0641\u0631\u0648\u0646\u061f<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_10' id='input_3_10' class='medium gfield_select'   aria-required=\"true\" aria-invalid=\"false\"><option value='\u0641\u064a \u063a\u0636\u0648\u0646 \u0627\u0644\u0623\u0633\u0628\u0648\u0639\u064a\u0646 \u0627\u0644\u0645\u0642\u0628\u0644\u064a\u0646' >\u0641\u064a \u063a\u0636\u0648\u0646 \u0627\u0644\u0623\u0633\u0628\u0648\u0639\u064a\u0646 \u0627\u0644\u0645\u0642\u0628\u0644\u064a\u0646<\/option><option value='\u0641\u064a \u063a\u0636\u0648\u0646 \u0627\u0644\u0634\u0647\u0631 \u0627\u0644\u062a\u0627\u0644\u064a' >\u0641\u064a \u063a\u0636\u0648\u0646 \u0627\u0644\u0634\u0647\u0631 \u0627\u0644\u062a\u0627\u0644\u064a<\/option><option value='\u0641\u064a \u063a\u0636\u0648\u0646 3 \u0623\u0634\u0647\u0631 \u0627\u0644\u0645\u0642\u0628\u0644\u0629' >\u0641\u064a \u063a\u0636\u0648\u0646 3 \u0623\u0634\u0647\u0631 \u0627\u0644\u0645\u0642\u0628\u0644\u0629<\/option><option value='\u0641\u064a \u063a\u0636\u0648\u0646 6 \u0623\u0634\u0647\u0631 \u0627\u0644\u0645\u0642\u0628\u0644\u0629' >\u0641\u064a \u063a\u0636\u0648\u0646 6 \u0623\u0634\u0647\u0631 \u0627\u0644\u0645\u0642\u0628\u0644\u0629<\/option><option value='\u0623\u0643\u062b\u0631 \u0645\u0646 6 \u0623\u0634\u0647\u0631 \u0627\u0644\u0645\u0642\u0628\u0644\u0629' >\u0623\u0643\u062b\u0631 \u0645\u0646 6 \u0623\u0634\u0647\u0631 \u0627\u0644\u0645\u0642\u0628\u0644\u0629<\/option><\/select><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer'>\n                        <input type='button' id='gform_previous_button_3_11' class='gform_previous_button button' value='\u0627\u0644\u062e\u0637\u0648\u0629 \u0627\u0644\u0633\u0627\u0628\u0642\u0629'  onclick='jQuery(\"#gform_target_page_number_3\").val(\"1\");  jQuery(\"#gform_3\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_3\").val(\"1\");  jQuery(\"#gform_3\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_3_11' class='gform_next_button button' value='\u0627\u0644\u062e\u0637\u0648\u0629 \u0627\u0644\u062a\u0627\u0644\u064a\u0629'  onclick='jQuery(\"#gform_target_page_number_3\").val(\"3\");  jQuery(\"#gform_3\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_3\").val(\"3\");  jQuery(\"#gform_3\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_3_3' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_3_3' class='gform_fields top_label form_sublabel_below description_below'><li id='field_3_12'  class='gfield gf_right_half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_3_12' >\u0627\u0644\u0625\u0633\u0645 \u0627\u0644\u062b\u0644\u0627\u062b\u064a<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_3_12' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_3_13'  class='gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_3_13' >\u0627\u0644\u0644\u0642\u0628<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_3_13' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_3_14'  class='gfield gf_right_half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_3_14' >\u0631\u0642\u0645 \u0627\u0644\u0625\u062a\u0635\u0627\u0644 \u0645\u0639 \u0627\u0644\u0645\u0641\u062a\u0627\u062d \u0627\u0644\u062f\u0648\u0644\u064a<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_14' id='input_3_14' type='text' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/li><li id='field_3_15'  class='gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_3_15' >\u0627\u0644\u0628\u0631\u064a\u062f \u0627\u0644\u0625\u0644\u0643\u062a\u0631\u0648\u0646\u064a<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_15' id='input_3_15' type='text' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\" \/>\n                        <\/div><\/li><li id='field_3_17'  class='gfield field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >\u0645\u0633\u0627\u0631 \u0627\u0644\u0625\u062a\u0635\u0627\u0644 \u0627\u0644\u0645\u0641\u0636\u0644<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_3_17'><li class='gchoice_3_17_1'>\n\t\t\t\t\t\t\t\t<input name='input_17.1' type='checkbox'  value='\u0627\u0644\u0628\u0631\u064a\u062f \u0627\u0644\u0625\u0644\u0643\u062a\u0631\u0648\u0646\u064a'  id='choice_3_17_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_17_1' id='label_3_17_1'>\u0627\u0644\u0628\u0631\u064a\u062f \u0627\u0644\u0625\u0644\u0643\u062a\u0631\u0648\u0646\u064a<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_3_17_2'>\n\t\t\t\t\t\t\t\t<input name='input_17.2' type='checkbox'  value='\u0648\u0627\u062a\u0633 \u0627\u0628'  id='choice_3_17_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_17_2' id='label_3_17_2'>\u0648\u0627\u062a\u0633 \u0627\u0628<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_3_17_3'>\n\t\t\t\t\t\t\t\t<input name='input_17.3' type='checkbox'  value='\u062a\u0644\u062c\u0631\u0627\u0645'  id='choice_3_17_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_17_3' id='label_3_17_3'>\u062a\u0644\u062c\u0631\u0627\u0645<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_3_17_4'>\n\t\t\t\t\t\t\t\t<input name='input_17.4' type='checkbox'  value='\u0627\u0644\u0647\u0627\u062a\u0641'  id='choice_3_17_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_17_4' id='label_3_17_4'>\u0627\u0644\u0647\u0627\u062a\u0641<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer'>\n                        <input type='button' id='gform_previous_button_3_18' class='gform_previous_button button' value='\u0627\u0644\u062e\u0637\u0648\u0629 \u0627\u0644\u0633\u0627\u0628\u0642\u0629'  onclick='jQuery(\"#gform_target_page_number_3\").val(\"2\");  jQuery(\"#gform_3\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_3\").val(\"2\");  jQuery(\"#gform_3\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_3_18' class='gform_next_button button' value='\u0627\u0644\u062e\u0637\u0648\u0629 \u0627\u0644\u062a\u0627\u0644\u064a\u0629'  onclick='jQuery(\"#gform_target_page_number_3\").val(\"4\");  jQuery(\"#gform_3\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_3\").val(\"4\");  jQuery(\"#gform_3\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_3_4' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_3_4' class='gform_fields top_label form_sublabel_below description_below'><li id='field_3_20'  class='gfield gf_right_half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >\u0645\u0627 \u0647\u064a \u0627\u0644\u062e\u062f\u0645\u0627\u062a \u0627\u0644\u062a\u064a \u062a\u0628\u062d\u062b\u0648\u0646 \u0639\u0646\u0647\u0627\u061f<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_3_20'><li class='gchoice_3_20_1'>\n\t\t\t\t\t\t\t\t<input name='input_20.1' type='checkbox'  value='\u062c\u0631\u0627\u062d\u0629 \u062a\u062c\u0645\u064a\u0644 \u0627\u0644\u0648\u062c\u0647'  id='choice_3_20_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_20_1' id='label_3_20_1'>\u062c\u0631\u0627\u062d\u0629 \u062a\u062c\u0645\u064a\u0644 \u0627\u0644\u0648\u062c\u0647<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_3_20_2'>\n\t\t\t\t\t\t\t\t<input name='input_20.2' type='checkbox'  value='\u062c\u0631\u0627\u062d\u0629 \u062a\u062c\u0645\u064a\u0644 \u0627\u0644\u062c\u0633\u0645'  id='choice_3_20_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_20_2' id='label_3_20_2'>\u062c\u0631\u0627\u062d\u0629 \u062a\u062c\u0645\u064a\u0644 \u0627\u0644\u062c\u0633\u0645<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_3_20_3'>\n\t\t\t\t\t\t\t\t<input name='input_20.3' type='checkbox'  value='\u0639\u0644\u0627\u062c \u0627\u0644\u0639\u0642\u0645 \u0648 \u0623\u0637\u0641\u0627\u0644 \u0623\u0646\u0627\u0628\u06cc\u0628'  id='choice_3_20_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_20_3' id='label_3_20_3'>\u0639\u0644\u0627\u062c \u0627\u0644\u0639\u0642\u0645 \u0648 \u0623\u0637\u0641\u0627\u0644 \u0623\u0646\u0627\u0628\u06cc\u0628<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_3_20_4'>\n\t\t\t\t\t\t\t\t<input name='input_20.4' type='checkbox'  value='\u0637\u0628 \u0627\u0644\u0623\u0633\u0646\u0627\u0646'  id='choice_3_20_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_20_4' id='label_3_20_4'>\u0637\u0628 \u0627\u0644\u0623\u0633\u0646\u0627\u0646<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_3_20_5'>\n\t\t\t\t\t\t\t\t<input name='input_20.5' type='checkbox'  value='\u0632\u0631\u0627\u0639\u0629 \u0627\u0644\u0634\u0639\u0631'  id='choice_3_20_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_20_5' id='label_3_20_5'>\u0632\u0631\u0627\u0639\u0629 \u0627\u0644\u0634\u0639\u0631<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_3_20_6'>\n\t\t\t\t\t\t\t\t<input name='input_20.6' type='checkbox'  value=': \u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0642\u0644\u0628 \u0648\u0627\u0644\u0623\u0648\u0639\u064a\u0629 \u0627\u0644\u062f\u0645\u0648\u064a\u0629'  id='choice_3_20_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_20_6' id='label_3_20_6'>: \u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0642\u0644\u0628 \u0648\u0627\u0644\u0623\u0648\u0639\u064a\u0629 \u0627\u0644\u062f\u0645\u0648\u064a\u0629<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_3_20_7'>\n\t\t\t\t\t\t\t\t<input name='input_20.7' type='checkbox'  value='\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0639\u064a\u0648\u0646'  id='choice_3_20_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_20_7' id='label_3_20_7'>\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0639\u064a\u0648\u0646<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_3_20_8'>\n\t\t\t\t\t\t\t\t<input name='input_20.8' type='checkbox'  value='\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0639\u0638\u0627\u0645'  id='choice_3_20_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_20_8' id='label_3_20_8'>\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0639\u0638\u0627\u0645<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_3_20_9'>\n\t\t\t\t\t\t\t\t<input name='input_20.9' type='checkbox'  value='\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0645\u0633\u0627\u0644\u0643 \u0627\u0644\u0628\u0648\u0644\u064a\u0629'  id='choice_3_20_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_20_9' id='label_3_20_9'>\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0645\u0633\u0627\u0644\u0643 \u0627\u0644\u0628\u0648\u0644\u064a\u0629<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_3_20_11'>\n\t\t\t\t\t\t\t\t<input name='input_20.11' type='checkbox'  value='\u062c\u0631\u0627\u062d\u0629 \u0625\u0646\u0642\u0627\u0635 \u0627\u0644\u0648\u0632\u0646 \u0648 \u0627\u0644\u0646\u062d\u062a'  id='choice_3_20_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_20_11' id='label_3_20_11'>\u062c\u0631\u0627\u062d\u0629 \u0625\u0646\u0642\u0627\u0635 \u0627\u0644\u0648\u0632\u0646 \u0648 \u0627\u0644\u0646\u062d\u062a<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_3_20_12'>\n\t\t\t\t\t\t\t\t<input name='input_20.12' type='checkbox'  value='\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u062c\u0647\u0627\u0632 \u0627\u0644\u0647\u0636\u0645\u064a'  id='choice_3_20_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_20_12' id='label_3_20_12'>\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u062c\u0647\u0627\u0632 \u0627\u0644\u0647\u0636\u0645\u064a<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_3_20_13'>\n\t\t\t\t\t\t\t\t<input name='input_20.13' type='checkbox'  value='\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0623\u0639\u0635\u0627\u0628'  id='choice_3_20_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_20_13' id='label_3_20_13'>\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0623\u0639\u0635\u0627\u0628<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id='field_3_21'  class='gfield gf_left_half field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_3_21' >\u0627\u0644\u0645\u0632\u064a\u062f \u0645\u0646 \u0627\u0644\u062a\u0641\u0627\u0635\u064a\u0644<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_21' id='input_3_21' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id='field_3_22'  class='gfield field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >\u062a\u062d\u0645\u064a\u0644 \u0627\u0644\u0635\u0648\u0631 \u0648\u0627\u0644\u062a\u0642\u0627\u0631\u06cc\u0631 \u0627\u0644\u0637\u0628\u064a\u0629<\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_3_22' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_3_22&quot;,&quot;container&quot;:&quot;gform_multifile_upload_3_22&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_3_22&quot;,&quot;filelist&quot;:&quot;gform_preview_3_22&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/golsateb.com\\\/?gf_page=fb909510e668946&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/golsateb.com\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/golsateb.com\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;\\u0627\\u0644\\u0645\\u0644\\u0641\\u0627\\u062a 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