W$C(13)S$X=0W"VA (119)",?10,$E(DT,4,5),"/",$E(DT,6,7),"/",$E(DT,2,3)W:('SIDE)&(PRTFL)?40,"PLEASE REFER ONLY TO '",$S(REF:"1. REFILL REQUEST",1:"2. RENEWAL ORDER"),"'"W:+$G(RXP)?100,"(PARTIAL)"W:$D(REPRINT)?110,"(REPRINT)"
W!,$P(PS,"^",2)W:('SIDE)&(PRTFL)?40,"INSTRUCTION ON REVERSE SIDE OF THIS FORM"W:'SIDE?102,"(Filled at ",$P(PS2,"^",2),")"
W!,?2,$S($D(PSMP(3)):PSMP(3),$D(PSMP(1)):"",1:ADDR(3))I'SIDEW?38,$S(ADDR(3)'="":ADDR(5),1:""),?64,"ROUTING: ",$S(MW="REGULAR":"MAIL",1:MW)W:PRTFL?83,"CITY/STATE/ZIP: ",$E(LINE,1,16)W:'PRTFL?83,"* THIS RX CAN NOT BE 'RENEWED'. *"
;NEWLABELWHITESPACE
I+$G(PSOBARS),'SIDE,$P(PSOPAR,"^",19)'=1SX="S",X2=PSOINST_"-"_RXW!,?40SX1=$XW@PSOBAR1,X2,@PSOBAR0,$C(13),!,$S($G(PS55)=2:"***DO NOT MAIL***",1:"**CRITICAL MEDICAL SHIPMENT**"),!
EFNLWS=1:1:6W!W:NLWS=5$S($G(PS55)=2:"***DO NOT MAIL***",1:"**CRITICAL MEDICAL SHIPMENT**")
W!,?8,"VA Medical Center"I'SIDEW?38,INT(1)
W!,$P(PS,"^")," ",$P(PS,"^",3),"-",$P(PS,"^",4)W:'SIDE?38,INT(2)I'SIDEW:PRTFL?83W:'PRTFL?83,"* PLEASE CONTACT YOUR PHYSICIAN. *"
W!,?4,RXN,?15,$E(DATE,4,5),"/",$E(DATE,6,7),"/",$E(DATE,2,3)," (",RXF+1," OF ",1+$P(RXY,"^",9),")"I'SIDEW?38,INT(3)W:(PRTFL)&('REF)?83,"***** FOR PHYSICIAN USE ONLY *****"W:'PRTFL?83,"**********************************"