.qu Name of drug
.qu e.g. tabs/drops/caps?
.qu strength
.qu amount
.qu dosage
.qu Warnings?
&es
&pname
&pad1
&pad2
&pad3


           VETERINARY PRESCRIPTION FOR AN ANIMAL UNDER MY CARE
&ef
_____________________________________________________________________________


FOR:   &client
       &address1
       &address2
       &address3
       &address4


Name of Animal: &animal


NAME OF DRUG:         &var0

FORMULATION:          &var1

STRENGTH:             &var2

AMOUNT:               &var3

DOSAGE:               &var4

WARNINGS:             &var5


                       FOR ANIMAL TREATMENT ONLY

_____________________________________________________________________________

     *** THIS FORM IS NOT TO BE USED FOR SCHEDULE 3 CONTROLLED DRUGS***




&es
SIGNED                        MRCVS



DATE: &date