<td width="12%"><div align="right"></div></td>
</tr>
</table>
</div></td>
</tr>
</table>
</div></td>
</tr>
</table></td>
</tr>
<tr>
<td valign="top"><table width="315" border="0" cellspacing="0" cellpadding="0">
<tr>
<td width="10"><img src="image/l-1.jpg" width="4" height="198"></td>
<td width="260" valign="top"><table width="304" border="0" cellpadding="0" cellspacing="0" background="image/k-9.jpg">
<tr>
<td colspan="4"><table width="305" height="141" border="0" cellpadding="0" cellspacing="0">
<tr>
<td height="141" valign="top"> <table width="201" height="132" border="0" align="center" cellpadding="0" cellspacing="0">
<tr>
<td height="16" colspan="2"> </td>
</tr>
<tr>
<td colspan="2" ><div align="center" class="jiben">基
本 信 息</div></td>
</tr>
<tr >
<td width="81">手机号码:</td>
<td width="120"> <input name="mbnum" type="text" id="mbnum" size="15"></td>
</tr>
<tr >
<td>姓名:</td>