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|- style="vertical-align:middle" | |- style="vertical-align:middle" | ||
|width=3%|{{{1|}}} | |width=3%|{{{1|}}} | ||
|width= | |width=27% style="vertical-align:middle;"|{{#if:{{{2}}}|<span style="white-space:nowrap;float:right;margin-left:.5em;">{{{2|}}}</span>|}}{{#if:{{{3}}}|<span style="font-size:80%;line-height:1.2">{{{3|}}}</span>|}} | ||
|width=20% style="text-align:right; font-weight:bold;"|{{{4|}}} | |width=20% style="text-align:right; font-weight:bold;"|{{{4|}}} | ||
|width=7% style="text-align:center; font-weight:bold;"|<span style="white-space:nowrap;display:inline">{{{5|}}}</span> | |width=7% style="text-align:center; font-weight:bold;"|<span style="white-space:nowrap;display:inline">{{{5|}}}</span> | ||
|width=20% style="font-weight:bold;"|{{{6|}}} | |width=20% style="font-weight:bold;"|{{{6|}}} | ||
|width= | |width=23% style="font-size:90%;"|{{{7|}}} | ||
|} | |} |