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  Date Doctor Allergies Medicines  
10/8/06 James Dohan Cough / Cold Xyzabcdefg

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Drug Description Dosage Route Frequency Duration Ordered Qty Instruction Cautionary  
ABCDEF AB CDEFGH 3 Oral 3 4 100 Sample Instruction Sample Cautionary  

   


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Drug Description Dosage Route Frequency Duration Ordered Qty Instruction Cautionary Special Instructions  
ABCDEF AB CDEFGH 3 Oral 3 4 100 Sample Instruction Sample Cautionary Sample Special Instructions