Prescription VORONOV MAXIM

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Prescription VORONOV MAXIM

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Binh Thuan Medical Service
Dr.DONG’S Polyclinic

Phan Thiet, Date... 06....../....12......./...2011..................
Name of the subscriber (patient):
VORONOV MAXIM
Date of brith:
29.11.1985..- Sex: Male.................
Address:
Room 4003, Sealion Resort, Phan Thiet, Viet Nam
Diagnosis :
Sun allergy on face
TREATMENT
Drugs :
1…Dexamethason 4mg ……………
X
05
Bottles/ Ampules/ Tablets/ Packets/
Creame
Morning……1.5 amp…………….Afternoon……………….……Evening…
1amp
( 2
days )
Injection……IM………

Drinking/ To apply (………….minutes before meal/…………minutes

after meal
2…Cetirizin
10 mg …
X
05
…… Bottles/ Ampules/ Tablets/
Packets/ Creame
Morning……1 tab…………………….Afternoon…………….…Evening
( 5
days)…
Injection……………

Drinking/ To apply (……30…….minutes before meal/………minutes

after meal)
3…Prednisolon 5mg
X … 20… Bottles/ Ampules/ Tablets/ Packets/
Creame
Morning… …2 tabs …….Afternoon………2tabs ………Evening ……………….
( 5
days )
Injection……………

Drinking/ To apply (………….minutes before meal/……30……minutes

after meal)
4.…Biafine ………………………...…. X
1…… Bottles/ Ampules/ Tablets/ Packets/ Creame
Morning………1 time………….Afternoon…………1 time……………Evening…1 time
( 7
days)
Injection…………… Drinking/ To apply (………….minutes before meal/…………minutes after
meal)
5…Vitamin C 1gr
X …1 tube … Bottles/ Ampules/ Tablets/ Packets/
Creame
Morning… …1 tab …….Afternoon………1 tab ………Evening ……………….
( 5
days )
Injection……………

Drinking/ To apply (………….minutes before meal/……30……minutes

after meal)

Surgery: ..........................................................................................................
Bandage change :
Instrutions :
- No alcohol for a week

-

Avoid strong sunlight for at least 5 days
Doctors’ Signature:

Add: 29A Nguyen Ñinh Chieu- Ham Tien ward - Phan Thiet City - Binh Thuan
Province - VIET NAM
Tel/ Fax : (+84)62 3741213
Mobile :
(+84) 918210504 - Email :
[email protected]

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