source: FOIAVistA/tag/r/CMOP-PSX/PSXLBLNR.m@ 876

Last change on this file since 876 was 628, checked in by George Lilly, 15 years ago

initial load of FOIAVistA 6/30/08 version

File size: 2.3 KB
Line 
1PSXLBLNR ;BIR/HTW,BAB-CMOP Labels-Non Refillable ;[ 12/18/97 12:48 PM ]
2 ;;2.0;CMOP;**1,10**;11 Apr 97
3TOP W !,?54,COPAY," Days Supply: ",$G(TAYS),?102,"Mfg ________ Lot# ________"
4 W !,SADD1,?102,"Tech__________RPh__________"
5 W !,SCITY,", ",SSTATE," ",SZIP
6 I $G(PSXBAR) S X="S",X2=BAR S X1=$X W ?54,@IOBARON,X2,@IOBAROFF,*13
7 E W !!!!
8 W "FORWARDING SERVICE REQUESTED"
9 I '$G(RENW) G NORENEW
10NOREFILL ;NO REFILLS REMAIN PRINT SECTION
11 W ?54,"* NO REFILLS REMAINING ** PHYSICIAN USE ONLY *"
12 W ! I $G(REGMAIL)=1 W ?21,"CERTIFIED MAIL"
13 W ?54,"*Signature:____________________________SC NSC*"
14 W !,?54,"*Print Name:_________________________________*"
15 W !,"***CRITICAL MEDICAL SHIPMENT***"
16 W ?54,"*DEA or VA#_________________Date_____________*"
17 W ?102,"Routing: MAIL"
18 W !,?54,"*Refills: 0 1 2 3 4 5 7 8 9 10 11 *"
19 W ?99,"*",?102,"Days Supply: ",$G(TAYS)," Cap: ",$S($G(CAP):"**NON-SAFETY**",1:"SAFETY")
20 W !,?54,"***** To be filled in VA Pharmacies only *****"
21 W ?102,"Isd: ",$G(ISD)," Exp: ",$G(EXPDT)
22 W !,PNAME,?54,$G(PADD1),?102,"Last fill: ",$G(REFLST)
23 W !,$G(PADD1),?54,$G(PADD2),?102,"Pat. St ",PSTAT," Clinic: ",CLINIC
24 W !,$G(PADD2),?54,$G(PADD3),?102,$S($G(WARN)'="":"DRUG WARNING "_$G(WARN),1:"")
25 W !,$G(PADD3),?54,$G(PADD4)
26 W !,$G(PADD4),?54,"*Indicate address change on back of this form"
27 W !,?54,"[ ] Permanent [ ] Temporary until ",$S($G(PTEMP)]"":PTEMP,1:"__/__/__")
28BAR I $G(PSXBAR) S X="S",X2=BAR,X1=$X W ?102,@IOBARON,X2,@IOBAROFF,*13
29 Q
30NORENEW W ?54,"*** This prescription CANNOT be renewed ***"
31 W !?21,$S($G(REGMAIL)=1:"CERTIFIED MAIL",1:""),?54,"*",?96,"*"
32 W !,?54,"* A NEW PRESCRIPTION IS REQUIRED *"
33 W !,"***CRITICAL MEDICAL SHIPMENT***",?54,"*",?96,"*"
34 W !,?54,"***** Please contact your physician *******"
35 W !,?54,$G(PADD1),?102,"Routing: MAIL"
36 W !,?54,PADD2,?102,"Days Supply: ",$G(TAYS)," Cap: ",$S($G(CAP):"**NON-SFTY**",1:"SAFETY")
37 W !,PNAME,?54,$G(PADD3),?102,"Isd: ",$G(ISD)," Exp: ",$G(EXPDT)
38 W !,PADD1,?54,$G(PADD4),?102,"Last Fill: ",$G(REFLST)
39 W !,PADD2,?54,"*Indicate address change on back of this form",?102,"Pat. Stat ",PSTAT," Clinic: ",CLINIC
40 W !,$G(PADD3),?54,"[ ] Permanent [ ] Temporary until ",$S($G(PTEMP)]"":PTEMP,1:"__/__/__")
41 W ?102,$S($G(WARN)'="":"DRUG WARNING "_$G(WARN),1:"")
42 W !,$G(PADD4)
43 I $G(PSXBAR) S X="S",X2=BAR,X1=$X W ?102,@IOBARON,X2,@IOBAROFF,*13
44 Q
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