[[static_erefill_header.html]]
Back to Homes | $loginname | Logout
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## Prescription Profile

$profiles
[[static_footer.html]] <
>

#### $store_name $store_phone

$welcome $patient $store

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

Order Refill Back to Patient List
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$patient_firstname $patient_lastname
$patient_line1$patient_address1 $patient_line2 $patient_address2, $patient_cityname$patient_city $patient_provincename$patient_prov $patient_postalcode$patient_postal

BirthDate: $patient_birthday Age:$patient_age Weight:$patient_weight

Doctor Name: $patient_doctorname

Facility: $patient_homename

Diets: $patient_nhdiet

Comments: $patient_nhcomment

Room:/Bed: $patient_nhroom/$patient_nhbed Area/Ward: $patient_ward Admission Date:$patient_nhadmitdate

Allergies:$patient_allergies

Conditions:$patient_conditions

Order Refill Back to Patient List
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Drug Info

Date: $profile_filldate

$profile_tradename $profile_drugstrength

$profile_genericname $profile_drugstrength

Rx#: $profile_rxnumber

$profile_doctor

$profile_instructions

Times: $profile_admintimes

Quantity: $profile_fillquantity

Repeats: $profile_repeats

Authorized: $profile_quantityauthorized

Remaining: $profile_quantityremaining

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