For this prescription paper needs fixed formatting

Hi, I need this prescription paper in a fixed formatting. Let me explain what I need. Each time filling in the name of patient, address, and so on ....any information the formatting gets distorted. I need this in a format that each line should squeeze in all text entered without disturbing the format. All "fillable itmes" eg allergies section and few sections at the bottom needs to be in same format as above. I hope am clear .