The document contains prescription forms from Drogalife Drugstore located in Brgy. 111, Poblacion, La Carlota City 6130. Each form has spaces to provide information such as generic name, brand name, manufacturer, lot number, dosage strength, expiry date, directions for use, prescribing physician, dispensing pharmacist, and patient name. There are 6 identical prescription forms shown.
The document contains prescription forms from Drogalife Drugstore located in Brgy. 111, Poblacion, La Carlota City 6130. Each form has spaces to provide information such as generic name, brand name, manufacturer, lot number, dosage strength, expiry date, directions for use, prescribing physician, dispensing pharmacist, and patient name. There are 6 identical prescription forms shown.
The document contains prescription forms from Drogalife Drugstore located in Brgy. 111, Poblacion, La Carlota City 6130. Each form has spaces to provide information such as generic name, brand name, manufacturer, lot number, dosage strength, expiry date, directions for use, prescribing physician, dispensing pharmacist, and patient name. There are 6 identical prescription forms shown.
The document contains prescription forms from Drogalife Drugstore located in Brgy. 111, Poblacion, La Carlota City 6130. Each form has spaces to provide information such as generic name, brand name, manufacturer, lot number, dosage strength, expiry date, directions for use, prescribing physician, dispensing pharmacist, and patient name. There are 6 identical prescription forms shown.
BRGY. 111, POBLACION, LA CARLOTA CITY 6130 BRGY. 111, POBLACION, LA CARLOTA CITY 6130
Generic name: Generic name:
Brand name: Brand name: Manufacturer: Lot no.: Manufacturer: Lot no.: Dosage strength: Expiry date: Dosage strength: Expiry date: Direction for use: Direction for use: Pharmacist: Pharmacist: Physician: Physician: Name of Patient: Name of Patient:
DROGALIFE DRUGSTORE DROGALIFE DRUGSTORE
BRGY. 111, POBLACION, LA CARLOTA CITY 6130 BRGY. 111, POBLACION, LA CARLOTA CITY 6130
Generic name: Generic name:
Brand name: Brand name: Manufacturer: Lot no.: Manufacturer: Lot no.: Dosage strength: Expiry date: Dosage strength: Expiry date: Direction for use: Direction for use: Pharmacist: Pharmacist: Physician: Physician: Name of Patient: Name of Patient:
DROGALIFE DRUGSTORE DROGALIFE DRUGSTORE
BRGY. 111, POBLACION, LA CARLOTA CITY 6130 BRGY. 111, POBLACION, LA CARLOTA CITY 6130
Generic name: Generic name:
Brand name: Brand name: Manufacturer: Lot no.: Manufacturer: Lot no.: Dosage strength: Expiry date: Dosage strength: Expiry date: Direction for use: Direction for use: Pharmacist: Pharmacist: Physician: Physician: Name of Patient: Name of Patient:
DROGALIFE DRUGSTORE DROGALIFE DRUGSTORE
BRGY. 111, POBLACION, LA CARLOTA CITY 6130 BRGY. 111, POBLACION, LA CARLOTA CITY 6130
Generic name: Generic name:
Brand name: Brand name: Manufacturer: Lot no.: Manufacturer: Lot no.: Dosage strength: Expiry date: Dosage strength: Expiry date: Direction for use: Direction for use: Pharmacist: Pharmacist: Physician: Physician: Name of Patient: Name of Patient:
DROGALIFE DRUGSTORE DROGALIFE DRUGSTORE
BRGY. 111, POBLACION, LA CARLOTA CITY 6130 BRGY. 111, POBLACION, LA CARLOTA CITY 6130
Generic name: Generic name:
Brand name: Brand name: Manufacturer: Lot no.: Manufacturer: Lot no.: Dosage strength: Expiry date: Dosage strength: Expiry date: Direction for use: Direction for use: Pharmacist: Pharmacist: Physician: Physician: Name of Patient: Name of Patient: