<?php

echo '
<li class="section_break">
	<label class="description" for="element_19">Tipo de Participação : </label>
	<span>
		<input id="element_19_1" name="t_participacao" class="element radio" type="radio" value="1" checked="checked"/>
		<label class="choice" for="element_19_1">Lista Negra</label>
		<input id="element_19_2" name="t_participacao" class="element radio" type="radio" value="2" />
		<label class="choice" for="element_19_2">Lista Branca</label>
	</span> 
</li>
<li class="section_break">
	<div class="right">
		<select class="element select medium" id="element_2_6" name="pais"> 
			<option value="" selected="selected"></option>
			<option value="Afghanistan" >Afghanistan</option>
			<option value="Albania" >Albania</option>
		</select>
		<label for="element_2_6">País</label>
	</div> 
</li>
<li id="li_3" >
	<label class="description" for="element_3">Telemóvel </label>
</li>
<li class="section_break">
	<h3>Participação do Caso na Polícia</h3>
	<p></p>
</li>
<li id="li_4" >
	<label class="description" for="element_4">Número do Processo </label>
	<div>
		<input id="element_4" name="n_processo" class="element text medium" type="text" maxlength="255" value=""/> 
	</div> 
</li>
<li id="li_5" >
	<label class="description" for="data_participacao">Data da Participação </label>
	<span>
		<input id="element_5_1" name="element_5_1" class="element text" size="2" maxlength="2" value="" type="text"> /
		<label for="element_5_1">MM</label>
	</span>
	<span>
		<input id="element_5_2" name="element_5_2" class="element text" size="2" maxlength="2" value="" type="text"> /
		<label for="element_5_2">DD</label>
	</span>
	<span>
		<input id="element_5_3" name="element_5_3" class="element text" size="4" maxlength="4" value="" type="text">
		<label for="element_5_3">YYYY</label>
	</span>
	<span id="calendar_5">
		<img id="cal_img_5" class="datepicker" src="calendar.gif" alt="Pick a date.">	
	</span>
</li>
<li id="li_6" >
	<label class="description" for="element_6">Posto Policial </label>
	<div>
		<input id="element_6" name="posto_p" class="element text medium" type="text" maxlength="255" value=""/> 
	</div> 
</li>
<li id="li_7" >
	<label class="description" for="element_7">Telefone do Posto </label>
	<div>
		<input id="element_7" name="telefone_p" class="element text medium" type="text" maxlength="255" value=""/> 
	</div> 
</li>
<li class="section_break">
	<h3>Dados do Objecto</h3>
	<p></p>
</li>
<li id="li_20" >
	<label class="description" for="element_20">Tipo de Objecto </label>
	<div>
		<select class="element select medium" id="element_20" name="t_objecto"> 
			<option value="1" selected="selected" onclick="automovel()">Automóvel</option>
			<option value="2" onclick="bicicleta()">Bicicleta</option>
			<option value="3" onclick="automovel()">Motorizada</option>
			<option value="4" onclick="telemovel()">Telemóvel</option>
			<option value="5" onclick="automovel()">Barco</option>
		</select>
	</div> 
</li>
<li id="li_11" >
	<label class="description" for="element_11">Marca </label>
	<div>
		<input id="element_11" name="marca" class="element text medium" type="text" maxlength="255" value=""/> 
	</div> 
</li>
<li id="li_12" >
	<label class="description" for="element_12">Modelo </label>
	<div>
		<input id="element_12" name="modelo" class="element text medium" type="text" maxlength="255" value=""/> 
	</div> 
</li>
<li id="li_13" >
	<label class="description" for="element_13">Número de Série </label>
	<div>
		<input id="element_13" name="n_serie" class="element text medium" type="text" maxlength="255" value=""/> 
	</div> 
</li>
<li id="li_14" >
	<label class="description" for="element_14">Matrícula </label>
	<div>
		<input id="element_14" name="matricula" class="element text medium" type="text" maxlength="255" value=""/> 
	</div> 
	</li>
<li id="li_15" >
	<label class="description" for="element_15">Número do Motor </label>
	<div>
		<input id="element_15" name="n_motor" class="element text medium" type="text" maxlength="255" value=""/> 
	</div> 
</li>
<li id="li_16" >
	<label class="description" for="element_16">Número do Quadro </label>
	<div>
		<input id="element_16" name="n_quadro" class="element text medium" type="text" maxlength="255" value=""/> 
	</div> 
</li>
<li id="li_17" >
	<label class="description" for="element_17">Descrição (detalhes específicos) </label>
	<div>
		<textarea id="element_17" name="descricao" class="element textarea medium"></textarea> 
	</div> 
</li>
<li id="li_18" >
	<label class="description" for="element_18">Imagem </label>
	<div>
		<input id="element_18" name="image" class="element file" type="file"/> 
	</div>  
</li>
'
?>