{"status":"success","response":"<div id=\"custom_forms\">\n\n<div class=\"report_row\" id=\"custom_field_row_1\"><h4>Nombre de d\u00e9c\u00e8s (Manifestants ou civils) \/ Number of casualties (protesters or civilians) <\/h4><input type=\"text\" name=\"custom_field[1]\" value=\"\" id=\"custom_field_1\" class=\"text custom_text\" \/><\/div><div class=\"report_row\" id=\"custom_field_row_2\"><h4>Nombre de bless\u00e9s (Manifestants ou civils) \/ Number of injured (protesters or civilians) <\/h4><input type=\"text\" name=\"custom_field[2]\" value=\"\" id=\"custom_field_2\" class=\"text custom_text\" \/><\/div><div class=\"report_row\" id=\"custom_field_row_3\"><h4>Nombre de d\u00e9c\u00e8s (presse) \/ Number of casualties (press) <\/h4><input type=\"text\" name=\"custom_field[3]\" value=\"\" id=\"custom_field_3\" class=\"text custom_text\" \/><\/div><div class=\"report_row\" id=\"custom_field_row_4\"><h4>Nombre de bless\u00e9s (presse) \/ Number of injured (press) <\/h4><input type=\"text\" name=\"custom_field[4]\" value=\"\" id=\"custom_field_4\" class=\"text custom_text\" \/><\/div><div class=\"report_row\" id=\"custom_field_row_5\"><h4>Nombre de d\u00e9c\u00e8s (police) \/ Number of casualties (police) <\/h4><input type=\"text\" name=\"custom_field[5]\" value=\"\" id=\"custom_field_5\" class=\"text custom_text\" \/><\/div><div class=\"report_row\" id=\"custom_field_row_6\"><h4>Nombre de bless\u00e9s (police) \/ Number of injured (police) <\/h4><input type=\"text\" name=\"custom_field[6]\" value=\"\" id=\"custom_field_6\" class=\"text custom_text\" \/><\/div><div class=\"report_row\" id=\"custom_field_row_7\"><h4>Nombre de d\u00e9c\u00e8s (militaires) \/ Number of casualties (military) <\/h4><input type=\"text\" name=\"custom_field[7]\" value=\"\" id=\"custom_field_7\" class=\"text custom_text\" \/><\/div><div class=\"report_row\" id=\"custom_field_row_8\"><h4>Nombre de bless\u00e9s (militaires) \/ Number of injured (military) <\/h4><input type=\"text\" name=\"custom_field[8]\" value=\"\" id=\"custom_field_8\" class=\"text custom_text\" \/><\/div><div class=\"report_row\" id=\"custom_field_row_9\"><h4>Nombre de d\u00e9c\u00e8s (indetermin\u00e9s) \/ Number of casualties (unknown) <\/h4><input type=\"text\" name=\"custom_field[9]\" value=\"\" id=\"custom_field_9\" class=\"text custom_text\" \/><\/div><div class=\"report_row\" id=\"custom_field_row_10\"><h4>Nombre de bless\u00e9s (indetermin\u00e9s) \/ Number of injured (unknown) <\/h4><input type=\"text\" name=\"custom_field[10]\" value=\"\" id=\"custom_field_10\" class=\"text custom_text\" \/><\/div><div class=\"report_row\" id=\"custom_field_row_11\"><h4>Nombre de tortur\u00e8 \/ Number of Tortures <\/h4><input type=\"text\" name=\"custom_field[11]\" value=\"\" id=\"custom_field_11\" class=\"text custom_text\" \/><\/div><div class=\"report_row\" id=\"custom_field_row_12\"><h4>Nombre de victims de violences sexuels \/ Number of victims of sexual violence <\/h4><input type=\"text\" name=\"custom_field[12]\" value=\"\" id=\"custom_field_12\" class=\"text custom_text\" \/><\/div><div class=\"report_row\" id=\"custom_field_row_13\"><h4>Nombre d'arrestations\/ Number of Arrests <\/h4><input type=\"text\" name=\"custom_field[13]\" value=\"\" id=\"custom_field_13\" class=\"text custom_text\" \/><\/div><div class=\"report_row\" id=\"custom_field_row_14\"><h4>Nombre d'enlevements\/ Number of Kidnappings <\/h4><input type=\"text\" name=\"custom_field[14]\" value=\"\" id=\"custom_field_14\" class=\"text custom_text\" \/><\/div><div class=\"report_row\" id=\"custom_field_row_16\"><h4>Nombre de bless\u00e9s (politiciens) \/ Number of injured (politicians) <\/h4><input type=\"text\" name=\"custom_field[16]\" value=\"\" id=\"custom_field_16\" class=\"text custom_text\" \/><\/div><div class=\"report_row\" id=\"custom_field_row_17\"><h4>Nombre de d\u00e9c\u00e8s (politiciens) \/ Number of casualties (politicians) <\/h4><input type=\"text\" name=\"custom_field[17]\" value=\"\" id=\"custom_field_17\" class=\"text custom_text\" \/><\/div><div class=\"report_row\" id=\"custom_field_row_15\"><h4>Number Unspecified <\/h4><span class=\"custom-field-option\"><label for=\"custom_field[15]\" > True <\/label><input type=\"radio\" name=\"custom_field[15]\" value=\"True\" id=\"custom_field_15\" \/><\/span><\/div><\/div>"}