After a bit of playing aoround I managed to get a template to get a Drug Label template to work for the 3 inch high tractor feed drug labels many users still use on their existing software systems and want to use in OpenVPMS

This is an archetype template so you need to set the archetype field in the template to Patient Medication Label. 

The Paper size details should be set to custom, portrait, height 3 , wdith 3 and Paper Units inches.

For Windows you need to setup a new Form Size of 3" X 3" and assign this as the default paper size in the printer driver.