John Smith, MD

Family and General Medicine

1600 Creekside Dr., Suite 3300

Folsom, CA 95630

voice (916) 984-0000

fax (916) 983-0000

This is a prescription for

James, Patricia dob 02/01/1926 76 & 3/12 y/o 4/9/02

941-0000 ---

Ongoing Meds

Dilantin 100 mg tid

Estropipate 0.625 qd

Hcthz 25 mg q AM

KCl 8 meq qd

Prednisone 5 mg qd

Pentasa 250 mg 4 qid

Quinine SO4 325 mg hs prn

Darvocet N 100 1 q 4-6 hr prn pain max #30/mo

vicodin 5 mg q 4-6 hr prn pain max #30/mo

QS 6 months, please. All of them may not be wanted at the present time.

John Smith, MD

C34000 AC 9030000 CoreMedicalConcepts.com Sec. Code 5801267aer