[[static_app_header.html]]


<form name="frm" action="$viewpharmacies_url"  method="post">

{$error{
<font color="#ff0000">$error</font><br>
<a href="#" onclick="Javascript: history.back(1);">Click here to return back to the order form</a>
}}



<div align="center">
	<table border="0" width="95%" cellspacing="0" cellpadding="0">
		<tr>
			<td width="100%" height="40">
				<div align="right">
					<table border="0" width="98%" cellspacing="0" cellpadding="0">
							<tr>
								<td class="blue-txta"><h1>Order Confirmation</h1></td>
								<td align="right">Welcome <b> $patient_firstname $patient_lastname</b></td>
								<td width="30" align="right"><img border="0" src="$staticimages_http_prefix/security.jpg" width="14" height="16" /></td>
								<td width="45" align="right"><a href="logout.php">Logout</a></td>
							</tr>				
					</table>
				</div>    
			</td>
		</tr>
		

<br>



<tr>
			<td width="100%" class="bluef" height="40">
			<div align="center">
									<table border="0" width="95%" cellspacing="0" cellpadding="1">
											<tr>
												<td class="white-txt"><h3>$store_name</h3></td>
												<td class="white-txt" align="right"><h3>Phone: $store_phone</h3></td>
											</tr>
											<tr>
												<td colspan="2" class="white-txt"><h3>$store_address,  $store_city</h3></td>
											</tr>
									</table>
      </div>
      
      </td>
</tr>

<table border="0" width="95%" cellspacing="0" cellpadding="1">
<tr>	  
<td width="100%" class="left-right top blue-txta" height="30" valign="middle">
Thank you $patient_firstname $patient_lastname </b><br>
 </td>
</tr>




<tr>
<td  class="left-right top blue-txta" height="30">You have successfully ordered the prescription(s) marked <font color="green">Ordered</font> below.</td></tr><br>
<tr>
<td class="left-right bottom blue-txta" height="30">If any of your orders <font color="red">failed</font>, please contact your pharmacy by phone at $store_phone.</td>



</tr><br>

</table>

<br/>

<table border="0" width="95%" cellspacing="0" cellpadding="1">
<tr>
	<td class="pad-lefta white-txt bluef white-border" height="25">DrugName</td>
	<td class="pad-lefta white-txt bluef white-border" height="25">Rx#</td>
	<td class="pad-lefta white-txt bluef white-border" height="25">Status</td>
</tr>
$rxs_main
</table>
<br>
<br>
<br>				
<input type="image" value="Submit" class="no-border" src="$staticimages_http_prefix/but-back-to-profile.jpg" />

</form>
<br>
<br>
[[static_footer.html]]

<<rxs>>
<tr bgcolor="#EEEEFF">
<td class="right bottom pad-lefta blue-txta" height="25" align="left" valign="top">$rxs_drugname</td>
<td class="right bottom pad-lefta blue-txta" height="25" align="left" valign="top">$rxs_rxnumber</td>
<td class="bottom pad-lefta blue-txta" height="25" align="left" valign="top"><font color="$rxs_color"><b>$rxs_status</b></font></td></tr>
<</rxs>>