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1. Save signed content to media storage.

2. Update Medication request in OPS DB:

   1. set status = 'REJECTED'

   2. set reject_reason_code = $.reject_reason_code

   3. set reject_reason = $.reject_reason

   4. set updated_by = user_id

   5. set updated_at = now()

   6. set rejected_by = user_id

   7. set rejected_at = now()

3. Send SMS for person

   1. If Medication request has program with medical program setting medication_request_notification_disabled request_notification_disabled = true, then don't send SMS.

      Else:

      1. Get authentication_method of person from MPI

      2. If authentication_method == OTP, then send SMS to a person from Medication request:

         1. Generate SMS text

            1. get template from reject_template_sms parameter

            2. enrich template with data from Medication request

         2. Send SMS to a person

4. Render response according to specification

5. Add new record to Event manager

6. if the medication request is based on the activity with quantity:

   1. Recalculate and set remaining_quantity for the activity as described at Create Medication Request: Validate based_on (p. 2.d.1 )and do not include current MR but include all MD which related to current MR