Prescription
Patient Name: ____________________________ Address: _________________________________ Rx
Date: _______________ Age: ________________
Vigamox 0.5% 3mL (moxifloxacin hydrochloride ophthalmic solution) Sig: 1gtt OD OS OU QID x 7 Days
Pred Forte 1% 5mL (prednisolone acetate ophthalmic suspension ) Sig: 1gtt OD OS OU QID x 7 Days  Refills: _______ Craig Beyer, D.O DEA #