document.writeln('<form action="http://www.vizaginfo.net/poll.php" method="post">');
document.writeln('<input type="hidden" name="do" value="pollvote" />');
document.writeln('<input type="hidden" name="pollid" value="5" />');
document.writeln('<p>Should GVMC do spot billing for water bills?</p>');
document.writeln('<input type="radio" name="optionnumber" value="1" id="rb_optionnumber_1" />Yes');
document.writeln('<br /><input type="radio" name="optionnumber" value="2" id="rb_optionnumber_2" />No');
document.writeln('<br /><input type="radio" name="optionnumber" value="3" id="rb_optionnumber_3" />Cant say');
document.writeln('<p><input type="image" src="http://www.vizaginfo.com/img/submit.gif" name="submit" title="Submit Vote" /></p>');
document.writeln('<p><a href="http://www.vizaginfo.net/poll.php?do=showresults&amp;pollid=5">View Poll Results</a></p></form>');