Paperwork Challenge: Medical Prescription

[bryanayalalugo]

Hello, hello, let's see who can make a better form! The topic for this one is a Doctor's prescription note template. The form will be both judged on it's content and appearance.

((Hint: If you are going to use the formatting tags, remember to use the code button and leave it as HTML). Good luck!

[Connor]

Better late than never! Here's my attempt, assuming medical records are kept.

 

 

 

Spoiler

[center][logo]

[b]MEDICAL PRESCRIPTION[/b]
[small]Always keep this form with you.[/small][/center]

[hr]

[center][small][i]To comply with Space Law and NanoTrasen policies, any controlled drug with prescribed dosage must be handwritten by the physician or physicians assistant.
This document must be photocopied, with one copy attached to the patient's medical record, another with the patient.[/i][/small][/center]

Name of patient: [small][field][/small]
Age: [small][field][/small]
Blood type: [small][field][/small]

[hr]

[center][b]LIST OF CURRENT MEDICATIONS[/b][/center]

Prescribed drug: [field]
Dosage: [field]
Reason for taking: [field]

Additional notes: [field]


PHYSICIAN'S SIGNATURE: [sign]

 

 

Edited May 9, 2019 by Connor
Put code behind spoiler.