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Model Prescription PDF
Model Prescription PDF
Issued by :
The Commissioner,
Food & Drug Administration, Maharashtra State,
Survey No. 341, Bandra Kurla Complex, Bandra (East), Mumbai - 400 051
web site:- fda.maharashtra.gov.in Email:- comm.fda-mah@nic.in
February-2014
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Introduction
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MAHARASHTRA MODEL PRESCRIPTION FORMAT
SexP3.......AgeP4 .......WeightP5………
RxD10
1) Name of Medicine M1, As far as possible, generic name in capital letters.
3)
Minimum size of the prescription blank should be: 14 X 21cm (A5 size)
A guide to the prescription format
The prescription should have following particulars pertaining to
Doctor, Patient and Medicines as indicated below -
D – About Doctor / Prescriber P – About Patient M – About Medicine
Act means - Drugs & Cosmetics Act 1940. Rules means - Drugs & Cosmetics Rules 1945
As per the Rule 65 (10) prescription shall be dated. The date of prescription
Date of is also essential to know the validity of prescription and to avoid misuse of
D6 prescription such prescription.
Doctor’s As per Rule 65 (10) prescription shall be signed by the person issuing it
D7 signature & with her / his usual signature and, therefore, the prescription shall have full
date signature of prescriber with date.
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As per Rule 65 (10), prescription shall specify the name and address of the
Patient’s full person for whose treatment it is given or name & address of the owner of
P1 name the animal if the drug is meant for veterinary use. Therefore, prescription
shall bear patient’s / animal owner’s full name.
As per Rule 65 (10), prescription shall specify the name and address of the
person for whose treatment it is given. It is also essential for follow up of
Patient’s full
P2 address
patient, or to get in touch with patient in case of dispensing or prescribing
errors and also essential for recall of medicines, if required. Therefore, the
prescription shall bear patient’s full address.
As certain drugs are gender specific, sex of the patient should be mentioned
P3 Patient’s sex
on prescription.
The drug dosages may differ with age of patient and, therefore, prescription
P4 Patient’s age
must bear patient’s age.
Patient’s The drug dosages may vary with weight of the patient, therefore,
P5 weight prescription may bear patient’s weight.
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General guidelines for Doctors / Prescriber
Sr.
No.
Suggestions
1. Changes in prescription :
If any changes are warranted in prescription please issue fresh prescription.