表单提交内容如下：
elder-name: jia zeng
elder-gender: 男
elder-age: 87
contact: 15387005059
question1: 5
question2: 5
question3: 5
question4: 5
question5: 5
question6: 5
question7: 5
question8: 5
question9: 5
question10: 5
total-score: 50
老人姓名
[text* elder-name class:cf7-input placeholder “请输入长者姓名”]
性别
[radio elder-gender default:1 “男” “女”]
年龄
[text* elder-age class:cf7-input placeholder “请输入年龄”]
联系方式
[text* contact class:cf7-input placeholder “请输入电话/微信”]
满意度测评
序号
测评内容
非常满意（5分）
满意（3分）
一般（2分）
不满意（0分）
1
您对老年食堂的就餐环境满意吗？
[radio question1 use_label_element default:1 “5”]
[radio question1 use_label_element “3”]
[radio question1 use_label_element “2”]
[radio question1 use_label_element “0”]
2
您对老年食堂的卫生状况满意吗？
[radio question2 use_label_element “5”]
[radio question2 use_label_element “3”]
[radio question2 use_label_element “2”]
[radio question2 use_label_element “0”]
3
您对老年食堂的服务秩序满意吗？
[radio question3 use_label_element “5”]
[radio question3 use_label_element “3”]
[radio question3 use_label_element “2”]
[radio question3 use_label_element “0”]
4
您对服务人员的个人卫生满意吗？
[radio question4 use_label_element “5”]
[radio question4 use_label_element “3”]
[radio question4 use_label_element “2”]
[radio question4 use_label_element “0”]
5
您对服务人员的服务态度满意吗？
[radio question5 use_label_element “5”]
[radio question5 use_label_element “3”]
[radio question5 use_label_element “2”]
[radio question5 use_label_element “0”]
6
您对老年食堂的饭菜品种满意吗？
[radio question6 use_label_element “5”]
[radio question6 use_label_element “3”]
[radio question6 use_label_element “2”]
[radio question6 use_label_element “0”]
7
您对老年食堂的饭菜质量满意吗？
[radio question7 use_label_element “5”]
[radio question7 use_label_element “3”]
[radio question7 use_label_element “2”]
[radio question7 use_label_element “0”]
8
您对老年食堂的饭菜口味满意吗？
[radio question8 use_label_element “5”]
[radio question8 use_label_element “3”]
[radio question8 use_label_element “2”]
[radio question8 use_label_element “0”]
9
您对老年食堂的饭菜分量满意吗？
[radio question9 use_label_element “5”]
[radio question9 use_label_element “3”]
[radio question9 use_label_element “2”]
[radio question9 use_label_element “0”]
10
您对老年食堂的菜品价格满意吗？
[radio question10 use_label_element “5”]
[radio question10 use_label_element “3”]
[radio question10 use_label_element “2”]
[radio question10 use_label_element “0”]
最终得分与建议
最终得分
0
请完成所有评分
[hidden total-score id:cf7-total-score]
意见或建议: 1