{% extends "site.html" %} {% block head %} {{ block.super }} {% include 'dispense-prepack-js-functions.html' %} {% endblock %} {% block pagehead %} {% include 'pagehead.html' %} {% endblock %} {% block content %}
{% csrf_token %} {% if function_error %}
  • {{ function_error }}
{% endif %} {% if show_success %}

Pre-Pack order submitted successfully.

{% endif %} {% if instance_id %} {{ prepack_form.num_cards }} {{ prepack_form.priority }} {{ prepack_form.package_type }}
{{ prepack_form.days_supply }} {{ prepack_form.pills_per_dose }} {% if show_calendar|upper == 'TRUE' %} {{ prepack_form.start_day }} {{ prepack_form.end_of_month }} {% else %} {% endif %} {% if ppk_mgr_enabled %} {{ prepack_form.add_to_ppk_wall }} {% else %} {% endif %}       
{{ prepack_form.batch_value }} {{ prepack_form.user_msg }} {% if user_entry == 'TECH' or user_entry == 'BOTH' %} {{ prepack_form.req_tech }} {% else %} {% endif %} {% if user_entry == 'RPH' or user_entry == 'BOTH' %} {{ prepack_form.req_rph }} {% else %} {% endif %} {% endif %}
{% include 'info-panel-canister-info.html' %} {% include 'info-panel-drug-info.html' %} {% include 'info-panel-replen-history.html' %}
{% include 'prepack-custom-fill-plan.html' %}
{% endblock %}