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Rx#
1340257
Written Date
2/7/20XX
 
Rx Expires
1 year
Name
Lily M. Hanson
Original Prescription
DOB
3/1/XXXX
Age
30
Ht/Wt
65 inches, 159 lbs
Lily M. Hanson
2/7/20XX
Cephalexin 500 mg Capsule
Dispense #20 (twenty)
Sig: i po q12h for skin infection
verbal order by Jaye Hawc
0
Norman Keyes
4-G Medical Arts Building
Toni Sanders
Address
1205 Edgewood Lane
Phone
785-555-1277
Product/Quantity/Refills/SIG
Prescribed
Cephalexin Cap
Strength
500 mg
 
Dispensed
Cephalexin 500 mg Capsule
Pres Qty
20
 
Dis Qty
20
 
Day Supply
10
 
Refills
0
 
SIG
Take 1 capsule by mouth every 12 hours for skin infection.
Pill Image & Dispensing Notes
DAW
2
Origin Code
2
 
Pill Image
Name
Norman Keyes
Address
4-G Medical Arts Building
Fax
785-555-3239
DEA
AK4132647
NPI
3816380925
Phone
785-555-3238
Dispensing
Notes