PRESCRIPTION
FOR A PATIENT WITH ORAL CANDIDIASIS
Name : Doctor’s name:
Age : Reg No.:
Sex:
Address:
DIAGNOSIS:
ORAL CANDIDIASIS
Rx
·
Tab.
FLUCANOZOLE 100mg
Dispense 14 capsules
Take one capsule daily for 14 days
·
CANDID MOUTH PAINT (CLOTRIMAZOLE 1% cream)
Apply cream on the affected area 3-4
times a day
Signature of the doctor
Date
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