Patent US3625547A successfully refreshed from Google Patents.
US3625547A
Expired / Lapsed
US
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Composite prescription form
Assignee: Individual
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Filing: 1969-05-09
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Granted: 1971-12-07
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Expires: 1989-05-09
Abstract
Abstract A composite prescription form comprising five individual form parts which are detachably secured together at their upper ends in a superposed relationship with respect to each other. The prescription form contains a plurality of preprinted information and the pharmacist types the form upon receiving a new prescription. The form is then separated with one portion of the first or top part being used as a prescription label and the other portion of the first part being filed for daily computation and record. The second part of the form is a sack label with the third part of the form being the prescription itself. The fourth part of the form is identical to the third part and provides a copy of the original prescription. The fifth part of the form is a three-line part which is separable from the form so that it may be secured to a permanent patient prescription ledger card. A modification of the form is also disclosed and is designed for use as a refill prescription form. The modification utilizes three parts which are substantially identical to parts 1, 2 and 5 of the first described forms, respectively.
Inventors
- 👤 William A Burke
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-27 15:24
CPC Classifications
B; B42; B42D; B42D5/00; B42D5/02; B42D15/00; Y; Y10; Y10S; Y10S283/00; Y10S283/90; Y10S462/00; Y10S462/902
Claims Analysis
Total Claims: 9
Claim 1
Independent Claim
168 words
A composite prescription form, comprising, at least a prescription label, a package label and a ledger card label detachably secured together in a superimposed relationship, and a transfer means for transferring impressions from one label to other of the labels positioned therebeneath, said prescription label having a perforated tear line provided thereon for facilitating the separation of said prescription label into first and second portions, said second portion being a record stub having a spindle perforation formed therein, said transfer means having a nontransfer area provided thereon so that the prescription ingredients will not be indicated on said package label but will be indicated on said second portion and on said ledger card label, a prescription sheet member removably positioned between two of the aforementioned labels, and an auxiliary prescription sheet member removably positioned beneath said prescription sheet member, said prescription label and said package label being substantially identical in size, said prescription sheet members having a substantially greater length than said prescription label and said package label.
Claim 2
Dependent Claim
168 words
A composite prescription form, comprising, at least a prescription label, a package label and a ledger card label detachably secured together in a superimposed relationship, and a transfer means for transferring impressions from one label to other of the labels positioned therebeneath, said prescription label having a perforated tear line provided thereon for facilitating the separation of said prescription label into first and second portions, said second portion being a record stub having a spindle perforation formed therein, said transfer means having a nontransfer area provided thereon so that the prescription ingredients will not be indicated on said package label but will be indicated on said second portion and on said ledger card label, a prescription sheet member removably positioned between two of the aforementioned labels, and an auxiliary prescription sheet member removably positioned beneath said prescription sheet member, said prescription label and said package label being substantially identical in size, said prescription sheet members having a substantially greater length than said prescription label and said package label.
Claim 3
Dependent Claim
88 words
A composite prescription form, comprising, at least a prescription label, a package label, a ledger card label and a prescription sheet member detachably secured together in a superimposed relationship, a transfer means for transferring impressions between the aforementioned labels and sheet member, said prescription label and said package label being substantially identical in size, said prescription sheet member having a substantially greater length than said labels so that certain prescription information may be imprinted on said prescription sheet member without imprinting said certain prescription information on said labels.
Claim 4
Dependent Claim
88 words
A composite prescription form, comprising, at least a prescription label, a package label, a ledger card label and a prescription sheet member detachably secured together in a superimposed relationship, a transfer means for transferring impressions between the aforementioned labels and sheet member, said prescription label and said package label being substantially identical in size, said prescription sheet member having a substantially greater length than said labels so that certain prescription information may be imprinted on said prescription sheet member without imprinting said certain prescription information on said labels.
Claim 5
Dependent Claim
46 words
The form of claim 2 wherein said ledger card label has a substantially shorter length than said prescription label and said package label so that certain prescription information imprinted on said prescription label and said package label will not be imprinted on said ledger card label.
Claim 6
Dependent Claim
114 words
A composite prescription form, comprising, at least a prescription label, a package label, and a ledger card label detachably secured together in a superimposed relationship, and a transfer means for transferring impressions from one label to other of the labels positioned therebeneath, said prescription label having a perforated tear line provided thereon for facilitating the separation of said prescription label into first and second portions, said second portion being a record stub having a spindle perforation formed therein, said transfer means having a nontransfer area provided thereon so that the prescription ingredients will not be indicated on said package label but will be indicated on said second portion and on said ledger card label.
Claim 7
Dependent Claim
114 words
A composite prescription form, comprising, at least a prescription label, a package label, and a ledger card label detachably secured together in a superimposed relationship, and a transfer means for transferring impressions from one label to other of the labels positioned therebeneath, said prescription label having a perforated tear line provided thereon for facilitating the separation of said prescription label into first and second portions, said second portion being a record stub having a spindle perforation formed therein, said transfer means having a nontransfer area provided thereon so that the prescription ingredients will not be indicated on said package label but will be indicated on said second portion and on said ledger card label.
Claim 8
Dependent Claim
19 words
The form of claim 4 wherein a prescription sheet member is removably positioned between two of the aforementioned labels.
Claim 9
Dependent Claim
19 words
The Form of claim 5 wherein an auxiliary prescription sheet member is removably positioned beneath said prescription sheet member.
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USPTO Annuity & Maintenance Windows
| Annuity Stage | Window Opens | Payment Deadline | Surcharge Period Until | Estimated Fee | Status |
|---|---|---|---|---|---|
| 3.5 Years (Year 4) | 1974-12-06 | 1975-06-07 | 1975-12-07 | $2000.00 | Window Closed / Lapsed |
| 7.5 Years (Year 8) | 1978-12-06 | 1979-06-07 | 1979-12-07 | $3760.00 | Window Closed / Lapsed |
| 11.5 Years (Year 12) | 1982-12-06 | 1983-06-07 | 1983-12-07 | $7700.00 | Window Closed / Lapsed |