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gchoice_4_9_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='\u0628\u062f'  id='choice_4_9_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_9_3' id='label_4_9_3' class='gform-field-label gform-field-label--type-inline'>\u0628\u062f<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_9_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f'  id='choice_4_9_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_9_4' id='label_4_9_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_12\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_12\" ><legend class='gfield_label gform-field-label' >- \u0627\u0637\u0644\u0627\u0639\u0627\u062a \u0641\u0646\u06cc \u062f\u0631 \u0686\u0647 \u0633\u0637\u062d\u06cc \u0628\u0648\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_12'>\n\t\t\t<div class='gchoice gchoice_4_12_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628'  id='choice_4_12_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_12_0' id='label_4_12_0' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_12_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='\u062e\u0648\u0628'  id='choice_4_12_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_12_1' id='label_4_12_1' class='gform-field-label gform-field-label--type-inline'>\u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_12_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='\u0645\u062a\u0648\u0633\u0637'  id='choice_4_12_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_12_2' id='label_4_12_2' class='gform-field-label gform-field-label--type-inline'>\u0645\u062a\u0648\u0633\u0637<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_12_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='\u0628\u062f'  id='choice_4_12_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_12_3' id='label_4_12_3' class='gform-field-label gform-field-label--type-inline'>\u0628\u062f<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_12_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f'  id='choice_4_12_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_12_4' id='label_4_12_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_11\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_11\" ><legend class='gfield_label gform-field-label' >-\t\u0634\u0646\u0627\u0633\u0627\u0626\u06cc \u0646\u06cc\u0627\u0632 \u0622\u0646 \u0645\u0631\u06a9\u0632 \u0648 \u062a\u0637\u0627\u0628\u0642 \u0622\u0646 \u0628\u0627 \u062a\u0648\u0644\u06cc\u062f\u0627\u062a \u0634\u0631\u06a9\u062a \u062f\u0631 \u0686\u0647 \u0633\u0637\u062d\u06cc \u0627\u0646\u062c\u0627\u0645 \u0634\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_11'>\n\t\t\t<div class='gchoice gchoice_4_11_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628'  id='choice_4_11_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_11_0' id='label_4_11_0' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_11_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='\u062e\u0648\u0628'  id='choice_4_11_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_11_1' id='label_4_11_1' class='gform-field-label gform-field-label--type-inline'>\u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_11_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='\u0645\u062a\u0648\u0633\u0637'  id='choice_4_11_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_11_2' id='label_4_11_2' class='gform-field-label gform-field-label--type-inline'>\u0645\u062a\u0648\u0633\u0637<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_11_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='\u0628\u062f'  id='choice_4_11_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_11_3' id='label_4_11_3' class='gform-field-label gform-field-label--type-inline'>\u0628\u062f<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_11_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f'  id='choice_4_11_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_11_4' id='label_4_11_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_10\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_10\" ><legend class='gfield_label gform-field-label' >-\t\u067e\u06cc\u06af\u06cc\u0631\u06cc \u0648 \u0633\u0631\u0639\u062a \u062f\u0631 \u0627\u0631\u0633\u0627\u0644 \u06a9\u0627\u062a\u0627\u0644\u0648\u06af \u060c \u067e\u06cc\u0634 \u0641\u0627\u06a9\u062a\u0648\u0631 \u0648 \u0642\u0631\u0627\u0631\u062f\u0627\u062f \u0686\u06af\u0648\u0646\u0647 \u0628\u0648\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_10'>\n\t\t\t<div class='gchoice gchoice_4_10_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628'  id='choice_4_10_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_10_0' id='label_4_10_0' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_10_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='\u062e\u0648\u0628'  id='choice_4_10_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_10_1' id='label_4_10_1' class='gform-field-label gform-field-label--type-inline'>\u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_10_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='\u0645\u062a\u0648\u0633\u0637'  id='choice_4_10_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_10_2' id='label_4_10_2' class='gform-field-label gform-field-label--type-inline'>\u0645\u062a\u0648\u0633\u0637<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_10_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='\u0628\u062f'  id='choice_4_10_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_10_3' id='label_4_10_3' class='gform-field-label gform-field-label--type-inline'>\u0628\u062f<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_10_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f'  id='choice_4_10_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_10_4' id='label_4_10_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_13\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_13\" ><h2 class=\"gform_title\">\n2- \u062a\u062d\u0648\u06cc\u0644 \u062f\u0633\u062a\u06af\u0627\u0647 :<\/h2>\n<\/div><fieldset id=\"field_4_14\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_14\" ><legend class='gfield_label gform-field-label' >- \u0622\u06cc\u0627 \u062f\u0631 \u0645\u0648\u0639\u062f \u0645\u0642\u0631\u0631 \u0627\u0646\u062c\u0627\u0645 \u0634\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_14'>\n\t\t\t<div class='gchoice gchoice_4_14_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='\u0632\u0648\u062f\u062a\u0631'  id='choice_4_14_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_14_0' id='label_4_14_0' class='gform-field-label gform-field-label--type-inline'>\u0632\u0648\u062f\u062a\u0631<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_14_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='\u0628\u0647 \u0645\u0648\u0642\u0639'  id='choice_4_14_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_14_1' id='label_4_14_1' class='gform-field-label gform-field-label--type-inline'>\u0628\u0647 \u0645\u0648\u0642\u0639<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_14_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='\u062e\u0648\u0628'  id='choice_4_14_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_14_2' id='label_4_14_2' class='gform-field-label gform-field-label--type-inline'>\u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_14_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='\u0628\u0627 \u062a\u0627\u062e\u06cc\u0631'  id='choice_4_14_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_14_3' id='label_4_14_3' class='gform-field-label gform-field-label--type-inline'>\u0628\u0627 \u062a\u0627\u062e\u06cc\u0631<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_14_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='\u0628\u0627 \u062f\u06cc\u0631\u06a9\u0631\u062f \u0632\u06cc\u0627\u062f'  id='choice_4_14_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_14_4' id='label_4_14_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0627 \u062f\u06cc\u0631\u06a9\u0631\u062f \u0632\u06cc\u0627\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_17\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_17\" ><legend class='gfield_label gform-field-label' >- \u0622\u06cc\u0627 \u0628\u0637\u0648\u0631 \u06a9\u0627\u0645\u0644 \u062a\u0645\u0627\u0645\u06cc \u0627\u062c\u0632\u0627\u0621 \u062f\u0633\u062a\u06af\u0627\u0647 \u062a\u062d\u0648\u06cc\u0644 \u0634\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_17'>\n\t\t\t<div class='gchoice gchoice_4_17_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='\u06a9\u0627\u0645\u0644\u0627'  id='choice_4_17_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_17_0' id='label_4_17_0' class='gform-field-label gform-field-label--type-inline'>\u06a9\u0627\u0645\u0644\u0627<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_17_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='\u0628\u0644\u06cc'  id='choice_4_17_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_17_1' id='label_4_17_1' class='gform-field-label gform-field-label--type-inline'>\u0628\u0644\u06cc<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_17_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='\u062a\u0642\u0631\u06cc\u0628\u0627'  id='choice_4_17_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_17_2' id='label_4_17_2' class='gform-field-label gform-field-label--type-inline'>\u062a\u0642\u0631\u06cc\u0628\u0627<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_17_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='\u062e\u06cc\u0631'  id='choice_4_17_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_17_3' id='label_4_17_3' class='gform-field-label gform-field-label--type-inline'>\u062e\u06cc\u0631<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_17_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='\u0627\u0635\u0644\u0627'  id='choice_4_17_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_17_4' id='label_4_17_4' class='gform-field-label gform-field-label--type-inline'>\u0627\u0635\u0644\u0627<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_16\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_16\" ><legend class='gfield_label gform-field-label' >- \u0633\u06cc\u0633\u062a\u0645 \u062a\u062d\u0648\u06cc\u0644 \u0648 \u0647\u0645\u0627\u0647\u0646\u06af\u06cc \u062f\u0631 \u0686\u0647 \u0633\u0637\u062d\u06cc \u0628\u0648\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_16'>\n\t\t\t<div class='gchoice gchoice_4_16_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628'  id='choice_4_16_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_16_0' id='label_4_16_0' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_16_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='\u062e\u0648\u0628'  id='choice_4_16_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_16_1' id='label_4_16_1' class='gform-field-label gform-field-label--type-inline'>\u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_16_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='\u0645\u062a\u0648\u0633\u0637'  id='choice_4_16_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_16_2' id='label_4_16_2' class='gform-field-label gform-field-label--type-inline'>\u0645\u062a\u0648\u0633\u0637<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_16_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='\u0628\u062f'  id='choice_4_16_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_16_3' id='label_4_16_3' class='gform-field-label gform-field-label--type-inline'>\u0628\u062f<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_16_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f'  id='choice_4_16_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_16_4' id='label_4_16_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_15\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_15\" ><legend class='gfield_label gform-field-label' >- \u0628\u0633\u062a\u0647 \u0628\u0646\u062f\u06cc \u062f\u0633\u062a\u06af\u0627\u0647 \u0686\u06af\u0648\u0646\u0647 \u0628\u0648\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_15'>\n\t\t\t<div class='gchoice gchoice_4_15_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628'  id='choice_4_15_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_15_0' id='label_4_15_0' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_15_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='\u062e\u0648\u0628'  id='choice_4_15_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_15_1' id='label_4_15_1' class='gform-field-label gform-field-label--type-inline'>\u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_15_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='\u0645\u062a\u0648\u0633\u0637'  id='choice_4_15_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_15_2' id='label_4_15_2' class='gform-field-label gform-field-label--type-inline'>\u0645\u062a\u0648\u0633\u0637<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_15_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='\u0628\u062f'  id='choice_4_15_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_15_3' id='label_4_15_3' class='gform-field-label gform-field-label--type-inline'>\u0628\u062f<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_15_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f'  id='choice_4_15_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_15_4' id='label_4_15_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_21\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_21\" ><h2 class=\"gform_title\">\n3- \u0646\u0635\u0628 \u0648 \u0631\u0627\u0647 \u0627\u0646\u062f\u0627\u0632\u06cc \u062f\u0633\u062a\u06af\u0627\u0647 :<\/h2>\n<\/div><fieldset id=\"field_4_20\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_20\" ><legend class='gfield_label gform-field-label' >- \u0641\u0627\u0635\u0644\u0647 \u0632\u0645\u0627\u0646\u06cc \u062f\u0631\u062e\u0648\u0627\u0633\u062a \u0628\u0631\u0627\u06cc \u0631\u0627\u0647 \u0627\u0646\u062f\u0627\u0632\u06cc \u062a\u0627 \u0645\u0631\u0627\u062c\u0639\u0647 \u0628\u0647 \u0622\u0646 \u0645\u062d\u0644 \u0686\u06af\u0648\u0646\u0647 \u0628\u0648\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_20'>\n\t\t\t<div class='gchoice gchoice_4_20_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628'  id='choice_4_20_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_20_0' id='label_4_20_0' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_20_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='\u062e\u0648\u0628'  id='choice_4_20_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_20_1' id='label_4_20_1' class='gform-field-label gform-field-label--type-inline'>\u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_20_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='\u0645\u062a\u0648\u0633\u0637'  id='choice_4_20_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_20_2' id='label_4_20_2' class='gform-field-label gform-field-label--type-inline'>\u0645\u062a\u0648\u0633\u0637<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_20_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='\u0628\u062f'  id='choice_4_20_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_20_3' id='label_4_20_3' class='gform-field-label gform-field-label--type-inline'>\u0628\u062f<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_20_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f'  id='choice_4_20_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_20_4' id='label_4_20_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_19\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_19\" ><legend class='gfield_label gform-field-label' >- \u0633\u0631\u0639\u062a \u062f\u0631 \u0646\u0635\u0628 \u0648 \u0631\u0627\u0647 \u0627\u0646\u062f\u0627\u0632\u06cc \u0686\u06af\u0648\u0646\u0647 \u0628\u0648\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_19'>\n\t\t\t<div class='gchoice gchoice_4_19_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628'  id='choice_4_19_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_19_0' id='label_4_19_0' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_19_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='\u062e\u0648\u0628'  id='choice_4_19_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_19_1' id='label_4_19_1' class='gform-field-label gform-field-label--type-inline'>\u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_19_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='\u0645\u062a\u0648\u0633\u0637'  id='choice_4_19_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_19_2' id='label_4_19_2' class='gform-field-label gform-field-label--type-inline'>\u0645\u062a\u0648\u0633\u0637<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_19_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='\u0628\u062f'  id='choice_4_19_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_19_3' id='label_4_19_3' class='gform-field-label gform-field-label--type-inline'>\u0628\u062f<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_19_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f'  id='choice_4_19_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_19_4' id='label_4_19_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_18\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_18\" ><legend class='gfield_label gform-field-label' >- \u06a9\u06cc\u0641\u06cc\u062a \u0631\u0627\u0647 \u0627\u0646\u062f\u0627\u0632\u06cc \u062f\u0631 \u0686\u0647 \u0633\u0637\u062d\u06cc \u0628\u0648\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_18'>\n\t\t\t<div class='gchoice gchoice_4_18_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628'  id='choice_4_18_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_18_0' id='label_4_18_0' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_18_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='\u062e\u0648\u0628'  id='choice_4_18_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_18_1' id='label_4_18_1' class='gform-field-label gform-field-label--type-inline'>\u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_18_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='\u0645\u062a\u0648\u0633\u0637'  id='choice_4_18_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_18_2' id='label_4_18_2' class='gform-field-label gform-field-label--type-inline'>\u0645\u062a\u0648\u0633\u0637<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_18_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='\u0628\u062f'  id='choice_4_18_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_18_3' id='label_4_18_3' class='gform-field-label gform-field-label--type-inline'>\u0628\u062f<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_18_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f'  id='choice_4_18_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_18_4' id='label_4_18_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_22\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_22\" ><h2 class=\"gform_title\">\n4- \u0622\u0645\u0648\u0632\u0634 \u062f\u0633\u062a\u06af\u0627\u0647 :<\/h2>\n<\/div><fieldset id=\"field_4_23\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_23\" ><legend class='gfield_label gform-field-label' >- \u0646\u0648\u0639 \u0628\u0631\u062e\u0648\u0631\u062f \u067e\u0631\u0633\u0646\u0644 \u0622\u0645\u0648\u0632\u0634 \u062f\u0647\u0646\u062f\u0647 \u0686\u06af\u0648\u0646\u0647 \u0628\u0648\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_23'>\n\t\t\t<div class='gchoice gchoice_4_23_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628'  id='choice_4_23_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_23_0' id='label_4_23_0' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_23_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='\u062e\u0648\u0628'  id='choice_4_23_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_23_1' id='label_4_23_1' class='gform-field-label gform-field-label--type-inline'>\u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_23_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='\u0645\u062a\u0648\u0633\u0637'  id='choice_4_23_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_23_2' id='label_4_23_2' class='gform-field-label gform-field-label--type-inline'>\u0645\u062a\u0648\u0633\u0637<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_23_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='\u0628\u062f'  id='choice_4_23_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_23_3' id='label_4_23_3' class='gform-field-label gform-field-label--type-inline'>\u0628\u062f<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_23_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f'  id='choice_4_23_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_23_4' id='label_4_23_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_27\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_27\" ><legend class='gfield_label gform-field-label' >- \u062a\u0633\u0644\u0637 \u0641\u0646\u06cc \u067e\u0631\u0633\u0646\u0644 \u0622\u0645\u0648\u0632\u0634 \u062f\u0647\u0646\u062f\u0647 \u062f\u0631 \u0686\u0647 \u0633\u0637\u062d\u06cc \u0628\u0648\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_27'>\n\t\t\t<div class='gchoice gchoice_4_27_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628'  id='choice_4_27_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_27_0' id='label_4_27_0' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_27_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='\u062e\u0648\u0628'  id='choice_4_27_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_27_1' id='label_4_27_1' class='gform-field-label gform-field-label--type-inline'>\u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_27_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='\u0645\u062a\u0648\u0633\u0637'  id='choice_4_27_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_27_2' id='label_4_27_2' class='gform-field-label gform-field-label--type-inline'>\u0645\u062a\u0648\u0633\u0637<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_27_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='\u0628\u062f'  id='choice_4_27_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_27_3' id='label_4_27_3' class='gform-field-label gform-field-label--type-inline'>\u0628\u062f<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_27_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f'  id='choice_4_27_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_27_4' id='label_4_27_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_26\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_26\" ><legend class='gfield_label gform-field-label' >- \u0645\u06cc\u0632\u0627\u0646 \u0642\u062f\u0631\u062a \u0627\u0646\u062a\u0642\u0627\u0644 \u0622\u0645\u0648\u0632\u0634 \u0628\u0647 \u0645\u0633\u0626\u0648\u0644\u06cc\u0646 \u0645\u0631\u0628\u0648\u0637\u0647 \u0622\u0646 \u0645\u0631\u06a9\u0632 \u0686\u06af\u0648\u0646\u0647 \u0628\u0648\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_26'>\n\t\t\t<div class='gchoice gchoice_4_26_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628'  id='choice_4_26_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_26_0' id='label_4_26_0' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_26_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='\u062e\u0648\u0628'  id='choice_4_26_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_26_1' id='label_4_26_1' class='gform-field-label gform-field-label--type-inline'>\u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_26_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='\u0645\u062a\u0648\u0633\u0637'  id='choice_4_26_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_26_2' id='label_4_26_2' class='gform-field-label gform-field-label--type-inline'>\u0645\u062a\u0648\u0633\u0637<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_26_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='\u0628\u062f'  id='choice_4_26_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_26_3' id='label_4_26_3' class='gform-field-label gform-field-label--type-inline'>\u0628\u062f<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_26_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f'  id='choice_4_26_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_26_4' id='label_4_26_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_25\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_25\" ><legend class='gfield_label gform-field-label' >- \u0637\u0648\u0644 \u0632\u0645\u0627\u0646 \u0622\u0645\u0648\u0632\u0634 \u0645\u0646\u0627\u0633\u0628 \u0628\u0648\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_25'>\n\t\t\t<div class='gchoice gchoice_4_25_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='\u06a9\u0627\u0645\u0644\u0627'  id='choice_4_25_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_25_0' id='label_4_25_0' class='gform-field-label gform-field-label--type-inline'>\u06a9\u0627\u0645\u0644\u0627<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_25_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='\u0628\u0644\u06cc'  id='choice_4_25_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_25_1' id='label_4_25_1' class='gform-field-label gform-field-label--type-inline'>\u0628\u0644\u06cc<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_25_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='\u062a\u0642\u0631\u06cc\u0628\u0627'  id='choice_4_25_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_25_2' id='label_4_25_2' class='gform-field-label gform-field-label--type-inline'>\u062a\u0642\u0631\u06cc\u0628\u0627<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_25_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='\u062e\u06cc\u0631'  id='choice_4_25_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_25_3' id='label_4_25_3' class='gform-field-label gform-field-label--type-inline'>\u062e\u06cc\u0631<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_25_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='\u0627\u0635\u0644\u0627'  id='choice_4_25_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_25_4' id='label_4_25_4' class='gform-field-label gform-field-label--type-inline'>\u0627\u0635\u0644\u0627<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_24\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_24\" ><legend class='gfield_label gform-field-label' >- \u062c\u0632\u0648\u0627\u062a \u0631\u0627\u0647\u0646\u0645\u0627 \u0648 \u0645\u06a9\u062a\u0648\u0628\u0627\u062a \u062f\u0633\u062a\u0648\u0631\u0627\u0644\u0639\u0645\u0644 \u06a9\u0627\u0631 \u0628\u0627 \u062f\u0633\u062a\u06af\u0627\u0647 \u062f\u0631 \u0686\u0647 \u0633\u0637\u062d\u06cc \u0628\u0648\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_24'>\n\t\t\t<div class='gchoice gchoice_4_24_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628'  id='choice_4_24_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_24_0' id='label_4_24_0' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_24_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='\u062e\u0648\u0628'  id='choice_4_24_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_24_1' id='label_4_24_1' class='gform-field-label gform-field-label--type-inline'>\u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_24_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='\u0645\u062a\u0648\u0633\u0637'  id='choice_4_24_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_24_2' id='label_4_24_2' class='gform-field-label gform-field-label--type-inline'>\u0645\u062a\u0648\u0633\u0637<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_24_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='\u0628\u062f'  id='choice_4_24_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_24_3' id='label_4_24_3' class='gform-field-label gform-field-label--type-inline'>\u0628\u062f<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_24_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f'  id='choice_4_24_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_24_4' id='label_4_24_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_28\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_28\" ><h2 class=\"gform_title\">\n5- \u06a9\u0627\u0631\u06a9\u0631\u062f \u062f\u0633\u062a\u06af\u0627\u0647 :<\/h2>\n<\/div><fieldset id=\"field_4_29\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_29\" ><legend class='gfield_label gform-field-label' >- \u062f\u0642\u062a \u062f\u0633\u062a\u06af\u0627\u0647 \u0686\u06af\u0648\u0646\u0647 \u0628\u0648\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_29'>\n\t\t\t<div class='gchoice gchoice_4_29_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628'  id='choice_4_29_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_29_0' id='label_4_29_0' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_29_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='\u062e\u0648\u0628'  id='choice_4_29_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_29_1' id='label_4_29_1' class='gform-field-label gform-field-label--type-inline'>\u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_29_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='\u0645\u062a\u0648\u0633\u0637'  id='choice_4_29_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_29_2' id='label_4_29_2' class='gform-field-label gform-field-label--type-inline'>\u0645\u062a\u0648\u0633\u0637<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_29_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='\u0628\u062f'  id='choice_4_29_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_29_3' id='label_4_29_3' class='gform-field-label gform-field-label--type-inline'>\u0628\u062f<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_29_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f'  id='choice_4_29_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_29_4' id='label_4_29_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_32\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_32\" ><legend class='gfield_label gform-field-label' >- \u062f\u0631\u0635\u062f \u062e\u0631\u0627\u0628\u06cc \u062f\u0633\u062a\u06af\u0627\u0647 \u0686\u06af\u0648\u0646\u0647 \u0628\u0648\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_32'>\n\t\t\t<div class='gchoice gchoice_4_32_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u06a9\u0645'  id='choice_4_32_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_32_0' id='label_4_32_0' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u06a9\u0645<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_32_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='\u06a9\u0645'  id='choice_4_32_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_32_1' id='label_4_32_1' class='gform-field-label gform-field-label--type-inline'>\u06a9\u0645<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_32_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='\u0645\u062a\u0648\u0633\u0637'  id='choice_4_32_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_32_2' id='label_4_32_2' class='gform-field-label gform-field-label--type-inline'>\u0645\u062a\u0648\u0633\u0637<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_32_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='\u0632\u06cc\u0627\u062f'  id='choice_4_32_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_32_3' id='label_4_32_3' class='gform-field-label gform-field-label--type-inline'>\u0632\u06cc\u0627\u062f<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_32_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u0632\u06cc\u0627\u062f'  id='choice_4_32_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_32_4' id='label_4_32_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u0632\u06cc\u0627\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_31\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_31\" ><legend class='gfield_label gform-field-label' >- \u06a9\u0627\u0631\u0627\u0626\u06cc \u062f\u0633\u062a\u06af\u0627\u0647 \u0648 \u0645\u0642\u062f\u0648\u0631\u0627\u062a \u0622\u0646 \u0686\u06af\u0648\u0646\u0647 \u0628\u0648\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_31'>\n\t\t\t<div class='gchoice gchoice_4_31_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628'  id='choice_4_31_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_31_0' id='label_4_31_0' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_31_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='\u062e\u0648\u0628'  id='choice_4_31_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_31_1' id='label_4_31_1' class='gform-field-label gform-field-label--type-inline'>\u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_31_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='\u0645\u062a\u0648\u0633\u0637'  id='choice_4_31_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_31_2' id='label_4_31_2' class='gform-field-label gform-field-label--type-inline'>\u0645\u062a\u0648\u0633\u0637<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_31_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='\u0628\u062f'  id='choice_4_31_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_31_3' id='label_4_31_3' class='gform-field-label gform-field-label--type-inline'>\u0628\u062f<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_31_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f'  id='choice_4_31_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_31_4' id='label_4_31_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_30\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_30\" ><legend class='gfield_label gform-field-label' >-\t\u0631\u0627\u062d\u062a\u06cc \u06a9\u0627\u0631 \u0628\u0627 \u062f\u0633\u062a\u06af\u0627\u0647 \u0686\u06af\u0648\u0646\u0647 \u0628\u0648\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_30'>\n\t\t\t<div class='gchoice gchoice_4_30_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628'  id='choice_4_30_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_30_0' id='label_4_30_0' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_30_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='\u062e\u0648\u0628'  id='choice_4_30_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_30_1' id='label_4_30_1' class='gform-field-label gform-field-label--type-inline'>\u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_30_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='\u0645\u062a\u0648\u0633\u0637'  id='choice_4_30_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_30_2' id='label_4_30_2' class='gform-field-label gform-field-label--type-inline'>\u0645\u062a\u0648\u0633\u0637<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_30_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='\u0628\u062f'  id='choice_4_30_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_30_3' id='label_4_30_3' class='gform-field-label gform-field-label--type-inline'>\u0628\u062f<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_30_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f'  id='choice_4_30_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_30_4' id='label_4_30_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_33\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_33\" ><h2 class=\"gform_title\">\n6- \u062e\u062f\u0645\u0627\u062a \u067e\u0633 \u0627\u0632 \u0641\u0631\u0648\u0634 :<\/h2>\n<\/div><fieldset id=\"field_4_34\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_34\" ><legend class='gfield_label gform-field-label' >- \u067e\u0634\u062a\u06cc\u0628\u0627\u0646\u06cc \u062a\u0644\u0641\u0646\u06cc \u062f\u0631 \u0686\u0647 \u0633\u0637\u062d\u06cc \u0628\u0648\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_34'>\n\t\t\t<div class='gchoice gchoice_4_34_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628'  id='choice_4_34_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_34_0' id='label_4_34_0' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_34_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='\u062e\u0648\u0628'  id='choice_4_34_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_34_1' id='label_4_34_1' class='gform-field-label gform-field-label--type-inline'>\u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_34_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='\u0645\u062a\u0648\u0633\u0637'  id='choice_4_34_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_34_2' id='label_4_34_2' class='gform-field-label gform-field-label--type-inline'>\u0645\u062a\u0648\u0633\u0637<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_34_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='\u0628\u062f'  id='choice_4_34_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_34_3' id='label_4_34_3' class='gform-field-label gform-field-label--type-inline'>\u0628\u062f<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_34_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f'  id='choice_4_34_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_34_4' id='label_4_34_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_38\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_38\" ><legend class='gfield_label gform-field-label' >- \u0628\u0631\u062e\u0648\u0631\u062f \u0645\u0633\u0626\u0648\u0644\u06cc\u0646 \u062e\u062f\u0645\u0627\u062a\u06cc \u0686\u06af\u0648\u0646\u0647 \u0628\u0648\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_38'>\n\t\t\t<div class='gchoice gchoice_4_38_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628'  id='choice_4_38_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_38_0' id='label_4_38_0' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_38_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='\u062e\u0648\u0628'  id='choice_4_38_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_38_1' id='label_4_38_1' class='gform-field-label gform-field-label--type-inline'>\u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_38_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='\u0645\u062a\u0648\u0633\u0637'  id='choice_4_38_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_38_2' id='label_4_38_2' class='gform-field-label gform-field-label--type-inline'>\u0645\u062a\u0648\u0633\u0637<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_38_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='\u0628\u062f'  id='choice_4_38_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_38_3' id='label_4_38_3' class='gform-field-label gform-field-label--type-inline'>\u0628\u062f<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_38_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f'  id='choice_4_38_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_38_4' id='label_4_38_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_37\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_37\" ><legend class='gfield_label gform-field-label' >- \u0633\u0631\u0639\u062a \u0648 \u067e\u06cc\u06af\u06cc\u0631\u06cc \u062f\u0631 \u0645\u0631\u0627\u062c\u0639\u0647 \u0628\u0647 \u0622\u0646 \u0645\u0631\u06a9\u0632 \u062f\u0631 \u0635\u0648\u0631\u062a \u0628\u0631\u0648\u0632 \u0645\u0634\u06a9\u0644 \u0686\u06af\u0648\u0646\u0647 \u0628\u0648\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_37'>\n\t\t\t<div class='gchoice gchoice_4_37_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628'  id='choice_4_37_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_37_0' id='label_4_37_0' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_37_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='\u062e\u0648\u0628'  id='choice_4_37_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_37_1' id='label_4_37_1' class='gform-field-label gform-field-label--type-inline'>\u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_37_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='\u0645\u062a\u0648\u0633\u0637'  id='choice_4_37_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_37_2' id='label_4_37_2' class='gform-field-label gform-field-label--type-inline'>\u0645\u062a\u0648\u0633\u0637<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_37_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='\u0628\u062f'  id='choice_4_37_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_37_3' id='label_4_37_3' class='gform-field-label gform-field-label--type-inline'>\u0628\u062f<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_37_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f'  id='choice_4_37_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_37_4' id='label_4_37_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_36\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_36\" ><legend class='gfield_label gform-field-label' >- \u06a9\u06cc\u0641\u06cc\u062a \u062e\u062f\u0645\u0627\u062a \u0641\u0646\u06cc \u0627\u0646\u062c\u0627\u0645 \u0634\u062f\u0647 \u062f\u0631 \u0686\u0647 \u0633\u0637\u062d\u06cc \u0628\u0648\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_36'>\n\t\t\t<div class='gchoice gchoice_4_36_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628'  id='choice_4_36_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_36_0' id='label_4_36_0' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_36_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='\u062e\u0648\u0628'  id='choice_4_36_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_36_1' id='label_4_36_1' class='gform-field-label gform-field-label--type-inline'>\u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_36_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='\u0645\u062a\u0648\u0633\u0637'  id='choice_4_36_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_36_2' id='label_4_36_2' class='gform-field-label gform-field-label--type-inline'>\u0645\u062a\u0648\u0633\u0637<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_36_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='\u0628\u062f'  id='choice_4_36_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_36_3' id='label_4_36_3' class='gform-field-label gform-field-label--type-inline'>\u0628\u062f<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_36_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f'  id='choice_4_36_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_36_4' id='label_4_36_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_35\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_35\" ><legend class='gfield_label gform-field-label' >- \u062a\u0633\u0644\u0637 \u0641\u0646\u06cc \u067e\u0631\u0633\u0646\u0644 \u0627\u0639\u0632\u0627\u0645\u06cc \u062f\u0631 \u0686\u0647 \u0633\u0637\u062d\u06cc \u0628\u0648\u062f\u0647 \u0627\u0633\u062a \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_35'>\n\t\t\t<div class='gchoice gchoice_4_35_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='\u06a9\u0627\u0645\u0644\u0627'  id='choice_4_35_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_35_0' id='label_4_35_0' class='gform-field-label gform-field-label--type-inline'>\u06a9\u0627\u0645\u0644\u0627<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_35_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='\u0628\u0644\u06cc'  id='choice_4_35_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_35_1' id='label_4_35_1' class='gform-field-label gform-field-label--type-inline'>\u0628\u0644\u06cc<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_35_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='\u062a\u0642\u0631\u06cc\u0628\u0627'  id='choice_4_35_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_35_2' id='label_4_35_2' class='gform-field-label gform-field-label--type-inline'>\u062a\u0642\u0631\u06cc\u0628\u0627<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_35_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='\u062e\u06cc\u0631'  id='choice_4_35_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_35_3' id='label_4_35_3' class='gform-field-label gform-field-label--type-inline'>\u062e\u06cc\u0631<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_35_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='\u0627\u0635\u0644\u0627'  id='choice_4_35_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_35_4' id='label_4_35_4' class='gform-field-label gform-field-label--type-inline'>\u0627\u0635\u0644\u0627<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_39\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_39\" ><h2 class=\"gform_title\">\n7- \u062f\u0631 \u0645\u062c\u0645\u0648\u0639 \u0627\u0632 \u062e\u0631\u06cc\u062f \u062f\u0633\u062a\u06af\u0627\u0647 \u0627\u0632 \u0634\u0631\u06a9\u062a \u0633\u0646\u062a\u0627\u0645 \u0631\u0636\u0627\u06cc\u062a \u062f\u0627\u0631\u06cc\u062f \u061f <\/h2>\n<\/div><fieldset id=\"field_4_40\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_40\" ><legend class='gfield_label gform-field-label' >- \u062f\u0631 \u0645\u062c\u0645\u0648\u0639 \u0627\u0632 \u062e\u0631\u06cc\u062f \u062f\u0633\u062a\u06af\u0627\u0647 \u0627\u0632 \u0634\u0631\u06a9\u062a \u0633\u0646\u062a\u0627\u0645 \u0631\u0636\u0627\u06cc\u062a \u062f\u0627\u0631\u06cc\u062f \u061f<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_40'>\n\t\t\t<div class='gchoice gchoice_4_40_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628'  id='choice_4_40_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_40_0' id='label_4_40_0' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_40_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='\u062e\u0648\u0628'  id='choice_4_40_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_40_1' id='label_4_40_1' class='gform-field-label gform-field-label--type-inline'>\u062e\u0648\u0628<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_40_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='\u0645\u062a\u0648\u0633\u0637'  id='choice_4_40_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_40_2' id='label_4_40_2' class='gform-field-label gform-field-label--type-inline'>\u0645\u062a\u0648\u0633\u0637<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_40_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='\u0628\u062f'  id='choice_4_40_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_40_3' id='label_4_40_3' class='gform-field-label gform-field-label--type-inline'>\u0628\u062f<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_40_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f'  id='choice_4_40_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_40_4' id='label_4_40_4' class='gform-field-label gform-field-label--type-inline'>\u0628\u0633\u06cc\u0627\u0631 \u0628\u062f<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_41\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_41\" ><label class='gfield_label gform-field-label' 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