PRESCRIPTION FOR A PATIENT SUFFERING FROM DYSMENORRHOEA
Name : Doctor’s name:
Age : Reg No.:
Sex:
Address:
DIAGNOSIS: DYSMENORRHOEA
Rx
TAB. MEPHENAMIC ACID 250 mg
Dispense 9 tablets
1 tablet to be taken 3 times a day for 3 days
Signature of the doctor
Date
Name : Doctor’s name:
Age : Reg No.:
Sex:
Address:
DIAGNOSIS: DYSMENORRHOEA
Rx
TAB. MEPHENAMIC ACID 250 mg
Dispense 9 tablets
1 tablet to be taken 3 times a day for 3 days
Signature of the doctor
Date
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