PRESCRIPTION FOR A PATIENT SUFFERING FROM GRAND
MAL EPILEPSY
Name : Doctor’s name:
Age : Reg No.:
Sex:
Address:
DIAGNOSIS: RHEUMATOID ARTHRITIS
Rx
Tab. METHOTREXATE 7.5 mg
Dispense 4 tablets
Take one tablet orally after food once in a week for 4 weeks
Tab. CELECOXIB 100mg
Dispense 10 tablets
Take one tablet orally in case of severe pain after food
Tab. FOLIC ACID 5mg
Dispense 7 tablets
Take one tablet orally once a day after food
Review after 1 week
Signature of the doctor
Date
MAL EPILEPSY
Name : Doctor’s name:
Age : Reg No.:
Sex:
Address:
DIAGNOSIS: RHEUMATOID ARTHRITIS
Rx
Tab. METHOTREXATE 7.5 mg
Dispense 4 tablets
Take one tablet orally after food once in a week for 4 weeks
Tab. CELECOXIB 100mg
Dispense 10 tablets
Take one tablet orally in case of severe pain after food
Tab. FOLIC ACID 5mg
Dispense 7 tablets
Take one tablet orally once a day after food
Review after 1 week
Signature of the doctor
Date
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