Prescription Template
| Medication Name | Purpose | Dosage | Route | Frequency |
|---|---|---|---|---|
| Expectorant | Removes phlegm | 1 tablet | Oral | Every 4 hours |
| Paracetamol | For fever | 1 tablet | Oral | Every 4 hours |
| Anti-biotic | Bacterial infection | 500mg | Oral | Every 8 hours |
| Vitamin C | Immune system | 500mg | Oral | Once a day |
| Vitamin D | Immune System | 1 tablet | Oral | Once a day |
A prescription template is a document that contains information about medications a physician has ordered for a patient. Healthcare providers who are licensed to prescribe medications and develop treatment plans for their patients can use a prescription template. This document is useful for various tasks, including verifying prescriptions, documenting a treatment regimen, and maintaining health records.
This prescription PDF template includes fields for the prescription number, prescription date, patient information, any health conditions, prescribed medications, physician information, and the physician’s signature. The form attached to the template uses the Input Table element to show the name of each medication and the purpose of or reason for its use, as well as dosage and frequency information. The form also uses the Unique ID widget, which automatically provides a unique number for each prescription. You can use Jotform’s PDF Editor to easily customize the layout and change the color theme of the resulting PDF.
Deposit Receipt
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Taxi Receipt Template
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