4 <style type=
"text/css" title=
"mystyles" media=
"all">
12 font-family:helvetica;
19 <body {$STYLE.BOTTOM_BG_LINE}
>
23 <tr><td colspan=
"2">{$process_result}
<br /><br /></td></tr>
26 <form name=
"send_prescription" method=
"post" action=
"{$TOP_ACTION}send&id={$prescription->id}" target=
"_new">
27 <input type=
"submit" name=
"submit" value=
"Print" style=
"width:85;"/>
28 <input type=
"hidden" name=
"process" value=
"{$PROCESS}" />
32 <form name=
"send_prescription" method=
"post" action=
"{$TOP_ACTION}send&id={$prescription->id}">
33 <tr><td><input type=
"submit" name=
"submit" value=
"Email" style=
"width:85;" /></td><td><input type=
"text" name=
"email_to" size=
"25" value=
"{$prescription->email_to}"></td></tr>
34 <tr><td><input type=
"submit" name=
"submit" value=
"Fax" style=
"width:85;"/></td><td><input type=
"text" name=
"fax_to" size=
"25" value=
"{$prescription->fax_to}" ></td></tr>
35 <input type=
"hidden" name=
"process" value=
"{$PROCESS}" />
37 <form name=
"send_prescription" method=
"post" action=
"{$TOP_ACTION}send&id={$prescription->id}" target=
"_new">
38 <tr><td><input type=
"submit" name=
"submit" value=
"Auto Send" style=
"width:85;" /></td><td>{html_options
name=
"pharmacy_id" options=$prescription-
>pharmacy-
>utility_pharmacy_array() selected=$prescription-
>provider-
>id}
</td></tr>
39 <input type=
"hidden" name=
"process" value=
"{$PROCESS}" />
40 <tr><td colspan=
"2" align=
"center"></td></tr>