mol.ro sony 100) 1900 2001 GT /224-24 Tick slow relas п п Soma on, Pharmacist: Distance Sow Affix patient identification
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mol.ro sony 100) 1900 2001 GT /224-24 Tick slow relas п п Soma on, Pharmacist: Distance Sow Affix patient identification label here and overleaf Attach ADR sticker URN: 5924113 Allergies and adverse drug reactions (ADR) Family name: MERCX TE ONE DNI known Unknown fick appropriate boxer completo details below initias Reaction/type/date Medicine for other Given names: EDWARD Address: 29 ARTHUL STEM PENTCILLIN ANAPHYLAXIS SG: MELTDN Vic 3051. 2012 Date of birth: 14 - JAN-1946 Sex: MV First prescriber to print patient name and check labg correct Weight (kay: 71 Height (m): 184 Sign MERCE som gecelerompa Goodlaw Dare 22:4:21 mended Regular medicines ition times Year 20 21 Date and month PRESCRIBER MUST ENTER administration times ។ Date Meg ne corint generic name 100/2000 ) PARACETATTOL 20/140012000 Oo Rudo DOSE Frequency and Now ancer timsa 200/1200/1200 2400 PO 14 TOS. 1480 100/1400 9200 Pharmacy 200 100/1200/1900/200 POST O P400 of PAIN JO Pregonba signature Prot your reme Contact 284 Date Medione (print generic name) anod, modified Tick 224.21 ed use TRAMADOL. slow please Route 5080 Dose Frequency and NOW enter times ablet, then half po. TAS t be gwallowed Indication Pharmacy FOST OP PAIN (C.) ushing 2000, Prosorber Signatura Print your name Contact ducation record loshlar. Goodman 284 Dale Medicine (print generic name) Toki 22.4.2 INSULIN glas Route Dase Frequency and NUW enter times Subcut 7u TAS 1220 indication Pharmacy Drovided T2DH. WITH Foe. 11794 Proinber signature Frint your name Contact 1 h goodinul GoogAW 294 Date 31 ) Medicine (print generic name) Tick if ATORVASTATIN slow Route Doso Frequency and NOW enter times amort. PO MANE 2000 Indication Pharmacy 7 CHOLESTEROL stering Prefiber signature Tbo chaled Print your name Contact h A Date Medicina (print ganername) ASPIRIN Tich it slow rolato Frequency and NOW enter times o 800 ber ® MANE Indication Pharmacy THO. © pour une Print your name Contact gooolton GOEDTAW 284 Date Eply 1122.4.21 NAPROXEN Ticky N slow Route release Frequency and NOW enter times (W MANE Indication 108vo Pharmacy XXXXXX 나게 . 7 Ae buat 22.4.21% ranse long werhot 284. 122.4.21 Print your name: Dose Route Po. loong Prespaber signature Medicine (print generic name) Dispense? Dose ᎵᎧ . log Post of PAIN CERJE ON 25-4.21 284. Presojiber Signature Print your name Contact Goolm Yes / No days dry.com Prescriber's signature: Dispense? Pharmaceutical review: