document.write('<img src="/rforms/captcha.php?str=mHahlmY=&type=1" align="absmiddle" alt="" />&nbsp;&nbsp;');
document.write('<input name="captchacode" type="text" class="captcha_field_style_forms" placeholder="Enter code here" />');
document.write('<input name="captchacodesalt" type="hidden" value="mHahlmY=" />');