<tr bgcolor="#FFFFFF" class="word"> 
            <td colspan="3"> <div align="center">
                <input name="f39" type="text" id="f39" value="" size="4">
                年<BR>
<input name="f39" type="text" id="f39" value="" size="2">
                月
                <input name="f39" type="text" id="f39" value="" size="2">
                日</div></td>
            <td colspan="11"><textarea name="f39" cols="76" id="f39"></textarea></td>
            <td><input name="f39" type="text" id="f39" value="" size="15"></td>
          </tr>
   <tr bgcolor="#FFFFFF" class="word"> 
            <td colspan="3"> <div align="center">
                <input name="f39" type="text" id="f39" value="" size="4">
                年<BR>
<input name="f39" type="text" id="f39" value="" size="2">
                月
                <input name="f39" type="text" id="f39" value="" size="2">
                日</div></td>
            <td colspan="11"><textarea name="f39" cols="76" id="f39"></textarea></td>
            <td><input name="f39" type="text" id="f39" value="" size="15"></td>
          </tr>