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    <td width="100%" class="left-nav"><a href="my_pharmacies.php">My Pharmacies</a></td>
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    <td width="100%" class="left-nav"><a href="my_cholesterol.php">My Cholesterol</a></td>
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          <td align="right">Welcome <b> George Jetson</b></td>
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          <td width="45" align="right"><a href="#">Logout</a></td>
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          <td class="blue-txta"><h1>Acer Pharmacy</h1></td>
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        </center>
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    <td width="100%" class="left-right" height="30"><b>123 James Street Hamilton
      | <a href="#">Map</a>
      | 905-455-0987 | <a href="#">Flyer</a></b></td>
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              <tr>
                <td align="center" valign="top" width="30%">
                  <img border="0" src="$staticimages_http_prefix/img.jpg" width="82" height="62"><br><br><b>INFORMATION<br>
                  LEAFLET</b></td>
                <td valign="top" width="75%">
                  <table border="0" width="100%" cellspacing="0" cellpadding="2">
                    <tr>
                      <td width="50%"><b>Date: 9/11/2009</b></td>
                      <td width="50%" align="right"><b>Rx#: </b>12345678</td>
                    </tr>
                    <tr>
                      <td width="100%" colspan="2"><b>NOVO-BISOPROL OL 5MG</b></td>
                    </tr>
                    <tr>
                      <td width="100%" colspan="2">(BISOPROLOL FUMARATE 5MG)</td>
                    </tr>
                    <tr>
                      <td width="100%" colspan="2">Dr. Mansbridge, Bruce</td>
                    </tr>
                    <tr>
                      <td width="100%" colspan="2">TAKE 1 TABLET  ONCE DAILY</td>
                    </tr>
                  </table>
                </td>
              </tr>
            </table>
          </td>
          <td width="20%" class="top right greena pad-lefta">
          Quantity: 10
          </td>
          <td width="20%" class="top right bottom blued" rowspan="4">
          <div align="center">
          <table border="0" width="100%" cellspacing="0" cellpadding="6">
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              <td width="100%" align="center"><img border="0" src="$staticimages_http_prefix/on-order.jpg" width="92" height="33"></td>
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              <td width="100%" align="center"><input type="checkbox" name="C1" value="ON" class="no-border"></td>
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              <td width="100%" align="center" class="red-txt">This item is already on Order</td>
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          <td width="20%" class="top right greena pad-lefta">
          Repeats: 7</td>
        </tr>
        <tr>
          <td width="20%" class="top right blueb pad-lefta">Authorized: 100</td>
        </tr>
        <tr>
          <td width="20%" class="top right bottom blueb pad-lefta">Remaining: 70</td>
        </tr>
      </table>
    </td>
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    <td width="100%" height="10"></td>
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    <td width="100%">
      <table border="0" width="100%" cellspacing="0" cellpadding="0">
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          <td width="60%" rowspan="4" class="left-top-right bottom blued" valign="top">
            <table border="0" width="100%" cellspacing="0" cellpadding="0">
              <tr>
                <td align="center" valign="top" width="30%">
                  <img border="0" src="$staticimages_http_prefix/img.jpg" width="82" height="62"><br><br><b>INFORMATION<br>
                  LEAFLET</b></td>
                <td valign="top" width="75%">
                  <table border="0" width="100%" cellspacing="0" cellpadding="2">
                    <tr>
                      <td width="50%"><b>Date: 9/11/2009</b></td>
                      <td width="50%" align="right"><b>Rx#: </b>12345678</td>
                    </tr>
                    <tr>
                      <td width="100%" colspan="2"><b>NOVO-BISOPROL OL 5MG</b></td>
                    </tr>
                    <tr>
                      <td width="100%" colspan="2">(BISOPROLOL FUMARATE 5MG)</td>
                    </tr>
                    <tr>
                      <td width="100%" colspan="2">Dr. Mansbridge, Bruce</td>
                    </tr>
                    <tr>
                      <td width="100%" colspan="2">TAKE 1 TABLET  ONCE DAILY</td>
                    </tr>
                  </table>
                </td>
              </tr>
            </table>
          </td>
          <td width="20%" class="top right greena pad-lefta">
          Quantity: 10
          </td>
          <td width="20%" class="top right bottom blued" rowspan="4">
          <div align="center">
          <table border="0" width="100%" cellspacing="0" cellpadding="6">
            <tr>
              <td width="100%" align="center"><img border="0" src="$staticimages_http_prefix/on-order.jpg" width="92" height="33"></td>
            </tr>
            <tr>
              <td width="100%" align="center"><input type="checkbox" name="C1" value="ON" class="no-border"></td>
            </tr>
            <tr>
              <td width="100%" align="center" class="red-txt">This item is already on Order</td>
            </tr>
          </table>
          </div>
          </td>
        </tr>
        <tr>
          <td width="20%" class="top right greena pad-lefta">
          Repeats: 7</td>
        </tr>
        <tr>
          <td width="20%" class="top right blueb pad-lefta">Authorized: 100</td>
        </tr>
        <tr>
          <td width="20%" class="top right bottom blueb pad-lefta">Remaining: 70</td>
        </tr>
      </table>
    </td>
  </tr>
</table>
</div>
      </td>
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    <tr>
      <td width="100%" height="20"></td>
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      <td width="100%" class="left right top bottom blued" height="40" align="center"><h2>Order Options</h2></td>
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          <center>
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              <td height="20"></td>
              <td width="10" align="center"></td>
              <td></td>
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            <tr>
              <td>*Delivery/Pickup</td>
              <td height="30" align="center">:</td>
              <td><select size="1" name="D1">
                  <option>Pickup</option>
                </select></td>
            </tr>
            <tr>
              <td>Email</td>
              <td height="30" align="center">:</td>
              <td><input type="text" name="T1" size="40"></td>
            </tr>
            <tr>
              <td>Delivery Address</td>
              <td height="30" align="center">:</td>
              <td><input type="text" name="T1" size="40"></td>
            </tr>
            <tr>
              <td>Special Instructions</td>
              <td height="30" align="center">:</td>
              <td><input type="text" name="T1" size="40"></td>
            </tr>
            <tr>
              <td height="20"></td>
              <td align="center"></td>
              <td></td>
            </tr>
          </table>
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      <td width="100%"><a href="#"><img border="0" src="$staticimages_http_prefix/but-order-refills.jpg" width="152" height="38"></a></td>
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