a- Name of Patient,
b- Name of Medication
c- strength (25mg),
d- Quantity (30 tablets)
e-Dosage( how the
medication will be taken)
f- Physician's signature
g- Physician's seal, with
registration number
h- Physician printed name, address
and phone number
Your Doctor has to Fax the prescription to the following fax number 954-416-1203