var html = "<div id=\"idmed\" style=\"border:1px solid #418181; width:282px;font-family:arial;font-size:12px;color:#000;padding-bottom:5px;\">" + 
	"<h3 style=\"margin-top:0;width:100%;background-color:#418181;font-size:14px;text-align:center;padding:3px 0\">" +
	"	<a href=\"http://www.idmed.com.br\" style=\"color:#FFF;text-decoration:none;\">Idmed - prontu&aacute;rio eletr&ocirc;nico</a></h3>" +
	"<form name=\"form_idmed\" target=\"_blank\" action=\"https://idmed1.websiteseguro.com/sistema/login_ext.php\" style=\"background-color:EBF6F0;padding:10px 0 0 53px;\" method=\"post\">" +
	"	<p>" + 
	"		<label style=\"width:70px; float:left; padding-top:2px;\">Login:</label>" +
	"		<input name=\"fr_username\" type=\"text\" id=\"fr_username\" style=\"background-color:F4FAF8;width:100px; height:18px; border:1px solid #777;\" />" +
	"	</p>" +
	"	<p>" +
	"		<label style=\"width:70px; float:left; padding-top:2px;\">Senha:</label>" +
	"		<input name=\"fr_password\" type=\"password\" id=\"fr_password\" style=\"background-color:F4FAF8;width:100px; height:18px; border:1px solid #777;\" />" +
	"	</p>" +
	"	<p>" +
	"   	<input type=\"submit\">" +
	"	</p>" +
	"	<p>" +
	"		<a style=\"color:#000;\" href=\"https://idmed1.websiteseguro.com/sistema/cadastraUsuario.php\">Cadastre-se</a>" +
	"	</p>" +
	"</form>" +
"</div>";
document.write(html);