| style="background-color:#BFEFFF;border-top:solid 1px #000;border-left:solid 1px #000;border-bottom:solid 1px #000" width="8" |   | style="background-color:#BFEFFF;border-top:solid 1px #000;border-bottom:solid 1px #000;text-align:center" width="70" |  {{{1}}} | style="background-color:#BFEFFF;border-top:solid 1px #000;border-right:solid 1px #000;border-bottom:solid 1px #000" width="8" |  

| style="border-bottom:1px solid #000" width="3" |