{"id":6818,"date":"2025-12-08T13:24:49","date_gmt":"2025-12-08T12:24:49","guid":{"rendered":"https:\/\/polyclinique-medina.com\/?page_id=6818"},"modified":"2025-12-10T17:02:44","modified_gmt":"2025-12-10T16:02:44","slug":"demande-devis","status":"publish","type":"page","link":"https:\/\/polyclinique-medina.com\/ar\/demande-devis\/","title":{"rendered":"\u0637\u0644\u0628 \u0639\u0631\u0636 \u0633\u0639\u0631"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"6818\" class=\"elementor elementor-6818\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-8da10be elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"8da10be\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-dccdd13\" data-id=\"dccdd13\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-47e9ce2 fluent-form-widget-step-header-yes fluent-form-widget-step-progressbar-yes fluentform-widget-submit-button-custom elementor-widget elementor-widget-fluent-form-widget\" data-id=\"47e9ce2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"fluent-form-widget.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\n            <div class=\"fluentform-widget-wrapper fluentform-widget-align-default\">\n\n                            <div class=\"fluentform-widget-heading\">\n                                        <h3 class=\"fluentform-widget-title\">\n                        Devis en ligne                    <\/h3>\n                                                            <p class=\"fluentform-widget-description\">\n                        Merci d&rsquo;enregistrer votre demande avec le dossier m\u00e9dical,notre r\u00e9ponse vous parviendra dans les meilleurs d\u00e9lais.                    <\/p>\n                                    <\/div>\n            \n            <div class='fluentform ff-default fluentform_wrapper_1 ffs_custom_wrap'><form data-form_id=\"1\" id=\"fluentform_1\" class=\"frm-fluent-form fluent_form_1 ff-el-form-top ff_form_instance_1_1 ff-form-loading ffs_custom\" data-form_instance=\"ff_form_instance_1_1\" method=\"POST\" ><fieldset  style=\"border: none!important;margin: 0!important;padding: 0!important;background-color: transparent!important;box-shadow: none!important;outline: none!important; min-inline-size: 100%;\">\n                    <legend class=\"ff_screen_reader_title\" style=\"display: block; margin: 0!important;padding: 0!important;height: 0!important;text-indent: -999999px;width: 0!important;overflow:hidden;\">Demande Devis<\/legend><input type='hidden' name='__fluent_form_embded_post_id' value='6818' \/><input type=\"hidden\" id=\"_fluentform_1_fluentformnonce\" name=\"_fluentform_1_fluentformnonce\" value=\"293e89e6de\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/ar\/wp-json\/wp\/v2\/pages\/6818\" \/><div data-type=\"name-element\" data-name=\"names\" class=\" ff-field_container ff-name-field-wrapper\" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_1_names_first_name_' id='label_ff_1_names_first_name_' >Nom<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names[first_name]\" id=\"ff_1_names_first_name_\" class=\"ff-el-form-control\" placeholder=\"Nom\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><div class='ff-t-cell '><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_1_names_last_name_' id='label_ff_1_names_last_name_' >Pr\u00e9nom<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names[last_name]\" id=\"ff_1_names_last_name_\" class=\"ff-el-form-control\" placeholder=\"Pr\u00e9nom\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_1\"  class='ff-t-container ff-column-container ff_columns_total_2 '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_1_phone' id='label_ff_1_phone' aria-label=\"T\u00e9l\u00e9phone\">T\u00e9l\u00e9phone<\/label><\/div><div class='ff-el-input--content'><input name=\"phone\" class=\"ff-el-form-control ff-el-phone\" type=\"tel\" placeholder=\"Num\u00e9ro de portable\" data-name=\"phone\" id=\"ff_1_phone\" inputmode=\"tel\"  aria-invalid='false' aria-required=true><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_1_email' id='label_ff_1_email' aria-label=\"Email\">Email<\/label><\/div><div class='ff-el-input--content'><input type=\"email\" name=\"email\" id=\"ff_1_email\" class=\"ff-el-form-control\" placeholder=\"Email Address\" data-name=\"email\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_2\"  class='ff-t-container ff-column-container ff_columns_total_2 '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group  ff_list_3col'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"\u00c9tat civil\">\u00c9tat civil<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_36ce73241d390bd84bc4d2cc3083615a'><input  type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Mr\"  id='input_radio_36ce73241d390bd84bc4d2cc3083615a' aria-label='Mr' aria-invalid='false' aria-required=true> <span>Mr<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_ce3fad884958c0640ec1978c8714fb72'><input  type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Mme\"  id='input_radio_ce3fad884958c0640ec1978c8714fb72' aria-label='Mme' aria-invalid='false' aria-required=true> <span>Mme<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_96ddacac53a0038ba3e056bbe75aa6f5'><input  type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Mlle\"  id='input_radio_96ddacac53a0038ba3e056bbe75aa6f5' aria-label='Mlle' aria-invalid='false' aria-required=true> <span>Mlle<\/span><\/label><\/div><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_1_numeric_field' id='label_ff_1_numeric_field' aria-label=\"\u00c2ge\">\u00c2ge<\/label><\/div><div class='ff-el-input--content'><input type=\"number\" name=\"numeric_field\" id=\"ff_1_numeric_field\" class=\"ff-el-form-control\" placeholder=\"\u00c2ge \" data-name=\"numeric_field\" inputmode=\"numeric\" step=\"any\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><div class=\"ff-name-address-wrapper fluent-address\" data-type=\"address-element\" data-name=\"address_1\" ><div class='ff-el-input--content'><div class='ff-t-container'><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_1_address_1_address_line_1_' id='label_ff_1_address_1_address_line_1_' aria-label=\"Adresse\">Adresse<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_1[address_line_1]\" id=\"ff_1_address_1_address_line_1_\" class=\"ff-el-form-control\" placeholder=\"Adresse\" data-key_name=\"address_line_1\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_1_address_1_city_' id='label_ff_1_address_1_city_' aria-label=\"Ville\">Ville<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_1[city]\" id=\"ff_1_address_1_city_\" class=\"ff-el-form-control\" placeholder=\"Ville\" data-key_name=\"city\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><\/div><div class='ff-t-container'><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_1_address_1_zip_' id='label_ff_1_address_1_zip_' aria-label=\"Code postal\">Code postal<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_1[zip]\" id=\"ff_1_address_1_zip_\" class=\"ff-el-form-control\" placeholder=\"Code postal\" data-key_name=\"zip\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_1_address_1_country_' id='label_ff_1_address_1_country_' aria-label=\"Pays\">Pays<\/label><\/div><div class='ff-el-input--content'><select name=\"address_1[country]\" id=\"ff_1_address_1_country_\" class=\"ff-el-form-control\" placeholder=\"S\u00e9lectionner le pays\" data-key_name=\"country\" aria-invalid='false' aria-required=false><option value=''>S\u00e9lectionner le pays<\/option><option value='GE' >Georgia<\/option><option value='IS' >\u0622\u064a\u0633\u0644\u0646\u062f\u0627<\/option><option value='ET' >\u0623\u062b\u064a\u0648\u0628\u064a\u0627<\/option><option value='AZ' >\u0623\u0630\u0631\u0628\u064a\u062c\u0627\u0646<\/option><option value='AM' >\u0623\u0631\u0645\u064a\u0646\u064a\u0627<\/option><option value='AW' >\u0623\u0631\u0648\u0628\u0627<\/option><option value='AU' >\u0623\u0633\u062a\u0631\u0627\u0644\u064a\u0627<\/option><option value='AF' >\u0623\u0641\u063a\u0627\u0646\u0633\u062a\u0627\u0646<\/option><option value='AL' >\u0623\u0644\u0628\u0627\u0646\u064a\u0627<\/option><option value='DE' >\u0623\u0644\u0645\u0627\u0646\u064a\u0627<\/option><option value='AG' >\u0623\u0646\u062a\u064a\u063a\u0648\u0627 \u0648\u0628\u0627\u0631\u0628\u0648\u062f\u0627<\/option><option value='AD' >\u0623\u0646\u062f\u0648\u0631\u0627<\/option><option value='AO' >\u0623\u0646\u063a\u0648\u0644\u0627<\/option><option value='AI' >\u0623\u0646\u063a\u0648\u064a\u0644\u0627<\/option><option value='UY' >\u0623\u0648\u0631\u0648\u063a\u0648\u0627\u064a<\/option><option value='UZ' >\u0623\u0648\u0632\u0628\u0643\u0633\u062a\u0627\u0646<\/option><option value='UG' >\u0623\u0648\u063a\u0646\u062f\u0627<\/option><option value='UA' >\u0623\u0648\u0643\u0631\u0627\u0646\u064a\u0627<\/option><option value='IE' >\u0623\u064a\u0631\u0644\u0646\u062f\u0627<\/option><option value='ER' >\u0625\u0631\u062a\u0631\u064a\u0627<\/option><option value='ES' >\u0625\u0633\u0628\u0627\u0646\u064a\u0627<\/option><option value='IL' >\u0625\u0633\u0631\u0627\u0626\u064a\u0644<\/option><option value='SZ' >\u0625\u0633\u0648\u0627\u062a\u064a\u0646\u064a<\/option><option value='IO' >\u0625\u0642\u0644\u064a\u0645 \u0627\u0644\u0645\u062d\u064a\u0637 \u0627\u0644\u0647\u0646\u062f\u064a \u0627\u0644\u0628\u0631\u064a\u0637\u0627\u0646\u064a<\/option><option value='ID' >\u0625\u0646\u062f\u0648\u0646\u064a\u0633\u064a\u0627<\/option><option value='IR' >\u0625\u064a\u0631\u0627\u0646<\/option><option value='IT' >\u0625\u064a\u0637\u0627\u0644\u064a\u0627<\/option><option value='EE' >\u0627\u0633\u062a\u0648\u0646\u064a\u0627<\/option><option value='PS' >\u0627\u0644\u0623\u0631\u0627\u0636\u064a \u0627\u0644\u0641\u0644\u0633\u0637\u064a\u0646\u064a\u0629<\/option><option value='AR' >\u0627\u0644\u0623\u0631\u062c\u0646\u062a\u064a\u0646<\/option><option value='JO' >\u0627\u0644\u0623\u0631\u062f\u0646<\/option><option value='TF' >\u0627\u0644\u0623\u0642\u0627\u0644\u064a\u0645 \u0627\u0644\u062c\u0646\u0648\u0628\u064a\u0629 \u0627\u0644\u0641\u0631\u0646\u0633\u064a\u0629<\/option><option value='AE' >\u0627\u0644\u0625\u0645\u0627\u0631\u0627\u062a \u0627\u0644\u0639\u0631\u0628\u064a\u0629 \u0627\u0644\u0645\u062a\u062d\u062f\u0629<\/option><option value='EC' >\u0627\u0644\u0627\u0643\u0648\u0627\u062f\u0648\u0631<\/option><option value='BH' >\u0627\u0644\u0628\u062d\u0631\u064a\u0646<\/option><option value='BR' >\u0627\u0644\u0628\u0631\u0627\u0632\u064a\u0644<\/option><option value='PT' >\u0627\u0644\u0628\u0631\u062a\u063a\u0627\u0644<\/option><option value='BS' >\u0627\u0644\u0628\u0647\u0627\u0645\u0627<\/option><option value='BA' >\u0627\u0644\u0628\u0648\u0633\u0646\u0629 \u0648\u0627\u0644\u0647\u0631\u0633\u0643<\/option><option value='PE' >\u0627\u0644\u0628\u064a\u0631\u0648<\/option><option value='ME' >\u0627\u0644\u062c\u0628\u0644 \u0627\u0644\u0623\u0633\u0648\u062f<\/option><option value='DZ' >\u0627\u0644\u062c\u0632\u0627\u0626\u0631<\/option><option value='DK' >\u0627\u0644\u062f\u0646\u0645\u0627\u0631\u0643<\/option><option value='DM' >\u0627\u0644\u062f\u0648\u0645\u064a\u0646\u064a\u0643\u0627\u0646<\/option><option value='CV' >\u0627\u0644\u0631\u0623\u0633 \u0627\u0644\u0623\u062e\u0636\u0631<\/option><option value='SV' >\u0627\u0644\u0633\u0644\u0641\u0627\u062f\u0648\u0631<\/option><option value='SN' >\u0627\u0644\u0633\u0646\u063a\u0627\u0644<\/option><option value='SD' >\u0627\u0644\u0633\u0648\u062f\u0627\u0646<\/option><option value='SE' >\u0627\u0644\u0633\u0648\u064a\u062f<\/option><option value='EH' >\u0627\u0644\u0635\u062d\u0631\u0627\u0621 \u0627\u0644\u063a\u0631\u0628\u064a\u0629<\/option><option value='SO' >\u0627\u0644\u0635\u0648\u0645\u0627\u0644<\/option><option value='CN' >\u0627\u0644\u0635\u064a\u0646<\/option><option value='IQ' >\u0627\u0644\u0639\u0631\u0627\u0642<\/option><option value='GA' >\u0627\u0644\u063a\u0627\u0628\u0648\u0646<\/option><option value='VA' >\u0627\u0644\u0641\u0627\u062a\u064a\u0643\u0627\u0646<\/option><option value='PH' >\u0627\u0644\u0641\u0644\u0628\u064a\u0646<\/option><option value='CM' >\u0627\u0644\u0643\u0627\u0645\u064a\u0631\u0648\u0646<\/option><option value='CG' >\u0627\u0644\u0643\u0648\u0646\u063a\u0648 (\u0628\u0631\u0627\u0632\u0627\u0641\u064a\u0644)<\/option><option value='CD' >\u0627\u0644\u0643\u0648\u0646\u063a\u0648 (\u0643\u064a\u0646\u0634\u0627\u0633\u0627)<\/option><option value='KW' >\u0627\u0644\u0643\u0648\u064a\u062a<\/option><option value='MV' >\u0627\u0644\u0645\u0627\u0644\u062f\u064a\u0641<\/option><option value='MA' >\u0627\u0644\u0645\u063a\u0631\u0628<\/option><option value='MX' >\u0627\u0644\u0645\u0643\u0633\u064a\u0643<\/option><option value='SA' >\u0627\u0644\u0645\u0645\u0644\u0643\u0629 \u0627\u0644\u0639\u0631\u0628\u064a\u0629 \u0627\u0644\u0633\u0639\u0648\u062f\u064a\u0629<\/option><option value='GB' >\u0627\u0644\u0645\u0645\u0644\u0643\u0629 \u0627\u0644\u0645\u062a\u062d\u062f\u0629<\/option><option value='AQ' >\u0627\u0644\u0645\u0646\u0637\u0642\u0629 \u0627\u0644\u0642\u0637\u0628\u064a\u0629 \u0627\u0644\u062c\u0646\u0648\u0628\u064a\u0629<\/option><option value='NO' >\u0627\u0644\u0646\u0631\u0648\u064a\u062c<\/option><option value='AT' >\u0627\u0644\u0646\u0645\u0633\u0627<\/option><option value='NE' >\u0627\u0644\u0646\u064a\u062c\u0631<\/option><option value='IN' >\u0627\u0644\u0647\u0646\u062f<\/option><option value='US' >\u0627\u0644\u0648\u0644\u0627\u064a\u0627\u062a \u0627\u0644\u0645\u062a\u062d\u062f\u0629 \u0627\u0644\u0623\u0645\u0631\u064a\u0643\u064a\u0629<\/option><option value='JP' >\u0627\u0644\u064a\u0627\u0628\u0627\u0646<\/option><option value='YE' >\u0627\u0644\u064a\u0645\u0646<\/option><option value='GR' >\u0627\u0644\u064a\u0648\u0646\u0627\u0646<\/option><option value='PG' >\u0628\u0627\u0628\u0648\u0627 \u063a\u064a\u0646\u064a\u0627 \u0627\u0644\u062c\u062f\u064a\u062f\u0629<\/option><option value='PY' >\u0628\u0627\u0631\u0627\u063a\u0648\u0627\u064a<\/option><option value='BB' >\u0628\u0627\u0631\u0628\u0627\u062f\u0648\u0633<\/option><option value='PK' >\u0628\u0627\u0643\u0633\u062a\u0627\u0646<\/option><option value='PW' >\u0628\u0627\u0644\u0627\u0648<\/option><option value='PA' >\u0628\u0627\u0646\u0645\u0627<\/option><option value='BM' >\u0628\u0631\u0645\u0648\u062f\u0627<\/option><option value='BN' >\u0628\u0631\u0648\u0646\u0627\u064a<\/option><option value='BE' >\u0628\u0644\u062c\u064a\u0643\u0627<\/option><option value='BG' >\u0628\u0644\u063a\u0627\u0631\u064a\u0627<\/option><option value='BZ' >\u0628\u0644\u064a\u0632<\/option><option value='BD' >\u0628\u0646\u063a\u0644\u0627\u062f\u064a\u0634<\/option><option value='BJ' >\u0628\u0646\u064a\u0646<\/option><option value='BT' >\u0628\u0648\u062a\u0627\u0646<\/option><option value='BW' >\u0628\u0648\u062a\u0633\u0648\u0627\u0646\u0627<\/option><option value='PR' >\u0628\u0648\u0631\u062a\u0648\u0631\u064a\u0643\u0648<\/option><option value='BF' >\u0628\u0648\u0631\u0643\u064a\u0646\u0627 \u0641\u0627\u0633\u0648<\/option><option value='BI' >\u0628\u0648\u0631\u0648\u0646\u062f\u064a<\/option><option value='PL' >\u0628\u0648\u0644\u0646\u062f\u0627<\/option><option value='BO' >\u0628\u0648\u0644\u064a\u0641\u064a\u0627<\/option><option value='PF' >\u0628\u0648\u0644\u064a\u0646\u064a\u0632\u064a\u0627 \u0627\u0644\u0641\u0631\u0646\u0633\u064a\u0629<\/option><option value='BQ' >\u0628\u0648\u0646\u064a\u0631 \u0648\u0633\u0627\u0646\u062a \u0623\u0648\u0633\u062a\u0627\u062a\u064a\u0648\u0633 \u0648\u0633\u0627\u0628\u0627<\/option><option value='PN' >\u0628\u064a\u062a\u0643\u064a\u0631\u0646<\/option><option value='BY' >\u0628\u064a\u0644\u0627\u0631\u0648\u0633\u064a\u0627<\/option><option value='TH' >\u062a\u0627\u064a\u0644\u0627\u0646\u062f<\/option><option value='TW' >\u062a\u0627\u064a\u0648\u0627\u0646<\/option><option value='TM' >\u062a\u0631\u0643\u0645\u0627\u0646\u0633\u062a\u0627\u0646<\/option><option value='TR' >\u062a\u0631\u0643\u064a\u0627<\/option><option value='TT' >\u062a\u0631\u064a\u0646\u062f\u0627\u062f \u0648\u062a\u0648\u0628\u0627\u063a\u0648<\/option><option value='TD' >\u062a\u0634\u0627\u062f<\/option><option value='CL' >\u062a\u0634\u064a\u0644\u064a<\/option><option value='TZ' >\u062a\u0646\u0632\u0627\u0646\u064a\u0627<\/option><option value='TG' >\u062a\u0648\u063a\u0648<\/option><option value='TV' >\u062a\u0648\u0641\u0627\u0644\u0648<\/option><option value='TK' >\u062a\u0648\u0643\u064a\u0644\u0627\u0648<\/option><option value='TN' >\u062a\u0648\u0646\u0633<\/option><option value='TO' >\u062a\u0648\u0646\u063a\u0627<\/option><option value='TL' >\u062a\u064a\u0645\u0648\u0631 \u0627\u0644\u0634\u0631\u0642\u064a\u0629<\/option><option value='JM' >\u062c\u0627\u0645\u0627\u064a\u0643\u0627<\/option><option value='GI' >\u062c\u0628\u0644 \u0637\u0627\u0631\u0642<\/option><option value='GL' >\u062c\u0631\u064a\u0646\u0644\u0627\u0646\u062f<\/option><option value='AX' >\u062c\u0632\u0631 \u0622\u0644\u0627\u0646\u062f<\/option><option value='VG' >\u062c\u0632\u0631 \u0627\u0644\u0639\u0630\u0631\u0627\u0621 (\u0627\u0644\u0645\u0645\u0644\u0643\u0629 \u0627\u0644\u0645\u062a\u062d\u062f\u0629)<\/option><option value='VI' >\u062c\u0632\u0631 \u0627\u0644\u0639\u0630\u0631\u0627\u0621 (\u0627\u0644\u0648\u0644\u0627\u064a\u0627\u062a \u0627\u0644\u0645\u062a\u062d\u062f\u0629 \u0627\u0644\u0623\u0645\u0631\u064a\u0643\u064a\u0629)<\/option><option value='KM' >\u062c\u0632\u0631 \u0627\u0644\u0642\u0645\u0631<\/option><option value='UM' >\u062c\u0632\u0631 \u0627\u0644\u0648\u0644\u0627\u064a\u0627\u062a \u0627\u0644\u0645\u062a\u062d\u062f\u0629 \u0627\u0644\u0635\u063a\u064a\u0631\u0629 \u0627\u0644\u0646\u0627\u0626\u064a\u0629<\/option><option value='TC' >\u062c\u0632\u0631 \u062a\u0648\u0631\u0643\u0633 \u0648\u0643\u0627\u064a\u0643\u0648\u0633<\/option><option value='SB' >\u062c\u0632\u0631 \u0633\u0644\u064a\u0645\u0627\u0646<\/option><option value='FO' >\u062c\u0632\u0631 \u0641\u0627\u0631\u0648<\/option><option value='FK' >\u062c\u0632\u0631 \u0641\u0648\u0643\u0644\u0627\u0646\u062f<\/option><option value='KY' >\u062c\u0632\u0631 \u0643\u0627\u064a\u0645\u0627\u0646<\/option><option value='CK' >\u062c\u0632\u0631 \u0643\u0648\u0643<\/option><option value='CC' >\u062c\u0632\u0631 \u0643\u0648\u0643\u0648\u0633 (\u0643\u064a\u0644\u064a\u0646\u063a)<\/option><option value='MH' >\u062c\u0632\u0631 \u0645\u0627\u0631\u0634\u0627\u0644<\/option><option value='MP' >\u062c\u0632\u0631 \u0645\u0627\u0631\u064a\u0627\u0646\u0627 \u0627\u0644\u0634\u0645\u0627\u0644\u064a\u0629<\/option><option value='BV' >\u062c\u0632\u064a\u0631\u0629 \u0628\u0648\u0641\u064a\u0647<\/option><option value='CX' >\u062c\u0632\u064a\u0631\u0629 \u0643\u0631\u064a\u0633\u0645\u0627\u0633<\/option><option value='IM' >\u062c\u0632\u064a\u0631\u0629 \u0645\u0627\u0646<\/option><option value='NF' >\u062c\u0632\u064a\u0631\u0629 \u0646\u0648\u0631\u0641\u0648\u0644\u0643<\/option><option value='HM' >\u062c\u0632\u064a\u0631\u0629 \u0647\u064a\u0631\u062f \u0648\u062c\u0632\u0631 \u0645\u0627\u0643\u062f\u0648\u0646\u0627\u0644\u062f<\/option><option value='CF' >\u062c\u0645\u0647\u0648\u0631\u064a\u0629 \u0625\u0641\u0631\u064a\u0642\u064a\u0627 \u0627\u0644\u0648\u0633\u0637\u0649<\/option><option value='CZ' >\u062c\u0645\u0647\u0648\u0631\u064a\u0629 \u0627\u0644\u062a\u0634\u064a\u0643<\/option><option value='DO' >\u062c\u0645\u0647\u0648\u0631\u064a\u0629 \u0627\u0644\u062f\u0648\u0645\u0646\u064a\u0643\u0627\u0646<\/option><option value='ZA' >\u062c\u0646\u0648\u0628 \u0623\u0641\u0631\u064a\u0642\u064a\u0627<\/option><option value='SS' >\u062c\u0646\u0648\u0628 \u0627\u0644\u0633\u0648\u062f\u0627\u0646<\/option><option value='GS' >\u062c\u0648\u0631\u062c\u064a\u0627 \u0627\u0644\u062c\u0646\u0648\u0628\u064a\u0629 \u0648\u062c\u0632\u0631 \u0633\u0627\u0646\u062f\u0648\u064a\u062a\u0634<\/option><option value='GF' >\u062c\u0648\u064a\u0627\u0646\u0627 \u0627\u0644\u0641\u0631\u0646\u0633\u064a\u0629<\/option><option value='DJ' >\u062c\u064a\u0628\u0648\u062a\u064a<\/option><option value='JE' >\u062c\u064a\u0631\u0632\u064a<\/option><option value='RW' >\u0631\u0648\u0627\u0646\u062f\u0627<\/option><option value='RU' >\u0631\u0648\u0633\u064a\u0627<\/option><option value='RO' >\u0631\u0648\u0645\u0627\u0646\u064a\u0627<\/option><option value='RE' >\u0631\u064a\u0648\u0646\u064a\u0648\u0646<\/option><option value='ZM' >\u0632\u0627\u0645\u0628\u064a\u0627<\/option><option value='ZW' >\u0632\u064a\u0645\u0628\u0627\u0628\u0648\u064a<\/option><option value='CI' >\u0633\u0627\u062d\u0644 \u0627\u0644\u0639\u0627\u062c<\/option><option value='WS' >\u0633\u0627\u0645\u0648\u0627<\/option><option value='AS' >\u0633\u0627\u0645\u0648\u0627 \u0627\u0644\u0623\u0645\u0631\u064a\u0643\u064a\u0629<\/option><option value='BL' >\u0633\u0627\u0646 \u0628\u0627\u0631\u062a\u064a\u0644\u0645\u064a<\/option><option value='PM' >\u0633\u0627\u0646 \u0628\u064a\u064a\u0631 \u0648\u0645\u064a\u0643\u0644\u0648\u0646<\/option><option value='SM' >\u0633\u0627\u0646 \u0645\u0627\u0631\u064a\u0646\u0648<\/option><option value='VC' >\u0633\u0627\u0646\u062a \u0641\u0646\u0633\u0646\u062a \u0648\u062c\u0632\u0631 \u063a\u0631\u064a\u0646\u0627\u062f\u064a\u0646<\/option><option value='KN' >\u0633\u0627\u0646\u062a \u0643\u064a\u062a\u0633 \u0648\u0646\u064a\u0641\u064a\u0633<\/option><option value='LC' >\u0633\u0627\u0646\u062a \u0644\u0648\u0633\u064a\u0627<\/option><option value='MF' >\u0633\u0627\u0646\u062a \u0645\u0627\u0631\u062a\u0646 (\u0627\u0644\u062c\u0632\u0621 \u0627\u0644\u0641\u0631\u0646\u0633\u064a)<\/option><option value='SX' >\u0633\u0627\u0646\u062a \u0645\u0627\u0631\u062a\u0646 (\u0627\u0644\u062c\u0632\u0621 \u0627\u0644\u0647\u0648\u0644\u0646\u062f\u064a)<\/option><option value='SH' >\u0633\u0627\u0646\u062a \u0647\u064a\u0644\u064a\u0646\u0627<\/option><option value='ST' >\u0633\u0627\u0648 \u062a\u0648\u0645\u064a \u0648\u0628\u0631\u064a\u0646\u0633\u064a\u0628\u064a<\/option><option value='LK' >\u0633\u0631\u064a\u0644\u0627\u0646\u0643\u0627<\/option><option value='SJ' >\u0633\u0641\u0627\u0644\u0628\u0627\u0631\u062f \u0648\u064a\u0627\u0646 \u0645\u0627\u064a\u0646<\/option><option value='SK' >\u0633\u0644\u0648\u0641\u0627\u0643\u064a\u0627<\/option><option value='SI' >\u0633\u0644\u0648\u0641\u064a\u0646\u064a\u0627<\/option><option value='SG' >\u0633\u0646\u063a\u0627\u0641\u0648\u0631\u0629<\/option><option value='SY' >\u0633\u0648\u0631\u064a\u0627<\/option><option value='SR' >\u0633\u0648\u0631\u064a\u0646\u0627\u0645<\/option><option value='CH' >\u0633\u0648\u064a\u0633\u0631\u0627<\/option><option value='SL' >\u0633\u064a\u0631\u0627\u0644\u064a\u0648\u0646<\/option><option value='SC' >\u0633\u064a\u0634\u064a\u0644<\/option><option value='RS' >\u0635\u0631\u0628\u064a\u0627<\/option><option value='TJ' >\u0637\u0627\u062c\u064a\u0643\u0633\u062a\u0627\u0646<\/option><option value='OM' >\u0639\u064f\u0645\u0627\u0646<\/option><option value='GM' >\u063a\u0627\u0645\u0628\u064a\u0627<\/option><option value='GH' >\u063a\u0627\u0646\u0627<\/option><option value='GD' >\u063a\u0631\u064a\u0646\u0627\u062f\u0627<\/option><option value='GT' >\u063a\u0648\u0627\u062a\u064a\u0645\u0627\u0644\u0627<\/option><option value='GP' >\u063a\u0648\u0627\u062f\u0644\u0648\u0628<\/option><option value='GU' >\u063a\u0648\u0627\u0645<\/option><option value='GY' >\u063a\u064a\u0627\u0646\u0627<\/option><option value='GG' >\u063a\u064a\u0631\u0646\u0633\u064a<\/option><option value='GN' >\u063a\u064a\u0646\u064a\u0627<\/option><option value='GQ' >\u063a\u064a\u0646\u064a\u0627 \u0627\u0644\u0627\u0633\u062a\u0648\u0627\u0626\u064a\u0629<\/option><option value='GW' >\u063a\u064a\u0646\u064a\u0627 \u0628\u064a\u0633\u0627\u0648<\/option><option value='VU' >\u0641\u0627\u0646\u0648\u0627\u062a\u0648<\/option><option value='FR' >\u0641\u0631\u0646\u0633\u0627<\/option><option value='VE' >\u0641\u0646\u0632\u0648\u064a\u0644\u0627<\/option><option value='FI' >\u0641\u0646\u0644\u0646\u062f\u0627<\/option><option value='VN' >\u0641\u064a\u062a\u0646\u0627\u0645<\/option><option value='FJ' >\u0641\u064a\u062c\u064a<\/option><option value='CY' >\u0642\u0628\u0631\u0635<\/option><option value='KG' >\u0642\u0631\u063a\u064a\u0632\u0633\u062a\u0627\u0646<\/option><option value='QA' >\u0642\u0637\u0631<\/option><option value='KZ' >\u0643\u0627\u0632\u0627\u062e\u0633\u062a\u0627\u0646<\/option><option value='NC' >\u0643\u0627\u0644\u064a\u062f\u0648\u0646\u064a\u0627 \u0627\u0644\u062c\u062f\u064a\u062f\u0629<\/option><option value='HR' >\u0643\u0631\u0648\u0627\u062a\u064a\u0627<\/option><option value='KH' >\u0643\u0645\u0628\u0648\u062f\u064a\u0627<\/option><option value='CA' >\u0643\u0646\u062f\u0627<\/option><option value='CU' >\u0643\u0648\u0628\u0627<\/option><option value='CW' >\u0643\u0648\u0631\u0627\u0633\u0627\u0648<\/option><option value='KR' >\u0643\u0648\u0631\u064a\u0627 \u0627\u0644\u062c\u0646\u0648\u0628\u064a\u0629<\/option><option value='KP' >\u0643\u0648\u0631\u064a\u0627 \u0627\u0644\u0634\u0645\u0627\u0644\u064a\u0629<\/option><option value='CR' >\u0643\u0648\u0633\u062a\u0627\u0631\u064a\u0643\u0627<\/option><option value='CO' >\u0643\u0648\u0644\u0648\u0645\u0628\u064a\u0627<\/option><option value='KI' >\u0643\u064a\u0631\u064a\u0628\u0627\u062a\u064a<\/option><option value='KE' >\u0643\u064a\u0646\u064a\u0627<\/option><option value='LV' >\u0644\u0627\u062a\u0641\u064a\u0627<\/option><option value='LA' >\u0644\u0627\u0648\u0633<\/option><option value='LB' >\u0644\u0628\u0646\u0627\u0646<\/option><option value='LU' >\u0644\u0648\u0643\u0633\u0645\u0628\u0648\u0631\u063a<\/option><option value='LY' >\u0644\u064a\u0628\u064a\u0627<\/option><option value='LR' >\u0644\u064a\u0628\u064a\u0631\u064a\u0627<\/option><option value='LT' >\u0644\u064a\u062a\u0648\u0627\u0646\u064a\u0627<\/option><option value='LI' >\u0644\u064a\u062e\u062a\u0646\u0634\u062a\u0627\u064a\u0646<\/option><option value='LS' >\u0644\u064a\u0633\u0648\u062a\u0648<\/option><option value='MQ' >\u0645\u0627\u0631\u062a\u064a\u0646\u064a\u0643<\/option><option value='MO' >\u0645\u0627\u0643\u0627\u0648<\/option><option value='MT' >\u0645\u0627\u0644\u0637\u0627<\/option><option value='ML' >\u0645\u0627\u0644\u064a<\/option><option value='MY' >\u0645\u0627\u0644\u064a\u0632\u064a\u0627<\/option><option value='YT' >\u0645\u0627\u064a\u0648\u062a<\/option><option value='MG' >\u0645\u062f\u063a\u0634\u0642\u0631<\/option><option value='EG' >\u0645\u0635\u0631<\/option><option value='XK' >\u0645\u0642\u0627\u0637\u0639\u0629 \u0643\u0648\u0633\u0648\u0641\u0648<\/option><option value='MK' >\u0645\u0642\u062f\u0648\u0646\u064a\u0627<\/option><option value='MW' >\u0645\u0644\u0627\u0648\u064a<\/option><option value='MN' >\u0645\u0646\u063a\u0648\u0644\u064a\u0627<\/option><option value='MR' >\u0645\u0648\u0631\u064a\u062a\u0627\u0646\u064a\u0627<\/option><option value='MU' >\u0645\u0648\u0631\u064a\u0634\u064a\u0648\u0633<\/option><option value='MZ' >\u0645\u0648\u0632\u0645\u0628\u064a\u0642<\/option><option value='MD' >\u0645\u0648\u0644\u062f\u0648\u0641\u0627<\/option><option value='MC' 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