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CLICK on an error to see if you found the mistake (1 error per prescription) |
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Rx# |
7412365 |
Written Date |
2/12/20XX |
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Rx Expires |
1 year |
Name |
Charles O. Elder |
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Original Prescription |
DOB |
1/6/XXXX |
Age |
16 |
Ht/Wt |
62 inches, 139 lbs |
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 |
Address |
940 Popular |
Phone |
785-555-9454 |
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Product/Quantity/Refills/SIG |
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Prescribed |
Zoloft Tab |
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Strength |
50 mg |
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Dispensed |
Sertraline 50 mg Tablet |
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Pres Qty |
30 |
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Dis Qty |
30 |
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Day Supply |
30 |
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Refills |
2 |
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SIG |
Take 1 tablet by mouth once daily for depression. |
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Pill Image & Dispensing Notes |
DAW |
0 |
Origin Code |
2 |
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Pill Image |
 |
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Name |
Norman Keyes |
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Address |
4-G Medical Arts Building |
Fax |
785-555-4187 |
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DEA |
AK4132647 |
NPI |
9999999999 |
Phone |
785-555-4186 |
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Dispensing Notes |
Mother reports Charles is combative and struggling with school work. |
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