[[static_erefill_header.html]] {$error{ $error
Click here to return back to the order form }}
Welcome $loginname Logout

## Order Confirmation

$store_name

Phone: $store_phone $store_address, $store_city

Thank-you $patient_firstname $patient_lastname

You have successfully ordered the prescription(s) marked Ordered

If any of your orders Failed, please contact your pharmacy by phone at $store_phone.

Rx Number | Drug Name | Status
--- | --- | ---
$rxs_main

Back to Patient List

[[static_footer.html]] <>

$rxs_rxnumber

$rxs_drugname

$rxs_status

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