"; pres+=""; pres+="\r\n"; pres+=" \r\n"; pres+="\r\n"; pres+="\r\n"; pres+="
\r\n"; pres+="

"+form.nom.value+"
"+form.dress.value+"
"+form.cszip.value+"
"; pres+="

Telephone: "+form.doctor_telephone.value+" DEA Reg #: "+form.DEAReg.value+"
Name: "+form.patient_name.value+"Age: "+form.age.value+"
Address: "+form.patient_address.value+"Date: "+form.date.value+"

Rx

"+form.total_prescription.value+"

Physician's Signature:
\r\n"; pres+="Physician's Name: "+form.nom.value+"

\r\n"; pres+="
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"; form.final_document.value=pres; } function WriteRx(form) { finDocument=window.open("","final_document","width=500,height=400,status=yes,toolbar=yes,menubar=yes,left=0,top=0,scrollbar=yes"); finDocument.document.open(); finDocument.document.write(form.final_document.value); finDocument.document.close(); } // End -->
Joe Sunny Software Home Products
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Joe Sunny Software : Prescription Writer

Doctor's Information
Name:
Address:

City, State, Zip:

Telephone:

DEA Reg #:

Patient's Information
Name:

Address:

Today's Date:

Age:

Prescription Information
Name of Drug:

Find Drugs
Dosage:

Number of Pills:

Directions for Use:

Total Prescription:



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