{% extends "hostis-main.html" %} {% block head %} {{ block.super }} {% endblock %} {% block pagehead %} {% include 'hostis-pagehead.html' %} {% endblock %} {% block content %}
{% csrf_token %} {% include 'report-table-header.html' %} {% include report_template %}
 
{% csrf_token %} {{ sig_formset.management_form }}
{{ edit_rx_form.id }}{{ edit_rx_form.status }}Rx Number: {{ edit_rx_form.rx_number }}    Quantity: {{ edit_rx_form.rx_quantity }}    Days: {{ edit_rx_form.days_supply }}
Fill Instance: {{ edit_rx_form.fill_instance }}    Total Refills: {{ edit_rx_form.total_refills }}    Refills Left: {{ edit_rx_form.refills_left }}
Patient: {{ pat_name }}    Doctor: {{ edit_rx_form.doctor }}
Dispensed Drug: {{ edit_rx_form.drug }}    Prescribed Drug: {{ edit_rx_form.prescribed_drug }}
Tech: {{ edit_rx_form.tech }}    Pharmacist: {{ edit_rx_form.rph }}    Entering Device: {{ edit_rx_form.entering_device }}
Original Date: {{ edit_rx_form.original_date }}    Entered Date: {{ edit_rx_form.entered_date }}    Start Date: {{ edit_rx_form.rx_start_date }}
Stop Date: {{ edit_rx_form.rx_stop_date }}    Expiration Date: {{ edit_rx_form.rx_expiration_date }}
Rx Barcode: {{ edit_rx_form.rx_barcode }}    Batch Id: {{ edit_rx_form.batch_id }}    Prior Rx Number: {{ edit_rx_form.prior_rx_number }}    Number of Labels: {{ edit_rx_form.number_of_labels }}
Notes: {{ edit_rx_form.rx_notes }}
{% for form in sig_formset %} {% if not forloop.first %} {% endif %}
{{ form.id }}{{ form.sig_number }} Sig Number: {{ form.sig_number.value }}    Sig Code: {{ form.sig_code }}    Number of Labels: {{ form.num_labels }}    PRN?: {{ form.is_prn }}
Sig Text: {{ form.sig_text }}
Qty Per Dose: {{ form.qty_per_dose }}    Qty Per Day: {{ form.qty_per_day }}    Admin Days: {{ form.admin_schedule }} Admin Times: {{ form.hoa }}
{% endfor %}
{% endblock %}