Indices:
$k$	Index of vehicles, $k\in \{1,2,\dots ,K\}$
$i,j$	Index of patients, $i,j\in \{1,2,\dots ,M\}$
$l$	Index of laboratories, $l\in \{1,2,\dots ,L\}$
$p$	Index of pharmacies, $p\in \{1,2,\dots ,P\}$
$t$	Index of time periods, $t\in \{1,2,\dots ,T\}$
$n$	Index of caregivers for each pharmacy, $n\in \{1,2,\dots ,N_p\}$
Parameters:
$D_{ij}^M$	Distance of patientsi and j
$D_{ip}^P$	Distance of patient i and pharmacy p
$D_{pl}^L$	Distance of pharmacy p and laboratory l
$CAP{P}_p$	The capacity of pharmacy p
$CAP{L}_l$	The capacity of laboratory l
$CS$	The allocation cost per unit distance
$T{C}_k$	The transportation cost for the vehicle k
$CA{P}_k$	The capacity of vehicle k
${\tilde{W}}_{it}$	The working time of the patient i in time period t
${\tilde{\lambda }}_{int}$	The privilege from patient i to the caregiver n in time period t
${\tilde{E}}_{it}$	The earliest time of servicing to the patient i in time period t
${\tilde{L}}_{it}$	The latest time of servicing to the patient i in time period t
${\tilde{T}}_{ijt}$	The traveling time of patients i to j in time period t
$PEN$	Penalty for overall distance ($1<PEN<5$ )
$BIG$	A positive large number
$MDI{S}_{nkt}$	Maximum length of the route for each caregiver n by employing vehicle k in time period t
$A_{it}$	Demands of patient i in time period t
$B_{it}$	Biological samples from patient i in time period t
Decision variables:
$X_{ijnpl}^{kt}$	If the caregiver n started from pharmacy p to laboratory l by using vehicle k visits the patients i before j in time period t; 1; otherwise 0.
$Z_{ip}^P$	If patient i assigned to pharmacy p, 1; otherwise 0.
$Z_{pl}^L$	If pharmacy p assigned to laboratory l, 1; otherwise 0.
$S_{inpl}^t$	The time in which the caregiver n started from pharmacy p to laboratory l begins to service the patient i in time period t.
$O_{nkpl}^t$	The overall traveleddistance for the caregiver n from pharmacy p to laboratory l using vehicle k in time period t.