HTML Scoresender Template

<div style="top: 0px;" class="module" id="gr-ctp-hiscores">
    <div class="container">
        <div class="left-rail"><div class="left"></div></div>
        <div class="mid-content">
            <div style="padding: 4px;">
                <table id="ss_table" style="left:-7px">
                    <tr><td colspan="2"><span>000</span> / <input type="text" name="number" value="150" maxlength="3" style="width:30px;" /> <img src="%%IMAGEM%%" style="vertical-align:bottom;width:30px;height:22px;cursor:pointer" /> <input type="text" name="captcha" style="margin-left:3px;width:30px;" maxlength="1" autocomplete="off" /> <input type="submit" value="Start!" name="send"></td></tr>
                    <tr><th colspan="2">Current</th></tr>
                    <tr><td width="21%">Score</td><td width="79%">0</td></tr>
                    <tr><td>Time</td><td>00:00</td></tr>
                    <tr><th colspan="2">History</th></tr>
                </table>
            </div>
        </div>
        <div class="right-rail"><div class="right"></div></div>
    </div>
    <div class="footer"><div class="footer-left"></div><div class="footer-right"></div></div>
    <div class="header"><div style="background: url(http://i42.tinypic.com/35k29at.png) no-repeat;" class="title"></div></div>
</div>
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