[[static_app_header.html]]
{$error{$error}} {!$error{
Welcome $patient_firstname $patient_lastname | Logout

## My Pharmacies

$store

Drug Detail | Status | Select
--- | --- | ---
$profile

### Order Options
*Delivery/Pickup Email Delivery Address Special Instructions

}} [[static_footer.html]] <>

$store_name

Phone: $store_phone

$store_address, $store_city <> <>

Date: $profile_filldate

$profile_tradename $profile_drugstrength

$profile_genericname $profile_drugstrength

Rx#: $profile_rxnumber

$profile_doctor

Quantity: $profile_fillquantity

Repeats: $profile_repeats

Authorized: $profile_quantityauthorized

Remaining: $profile_quantityremaining

{$orderable{
}} $profile_reason
<> <> $select_item <>