Flyingsamselhongo.com
FLYING SAMARITANS EL HONGO CLINIC
PHARMACY ORDER SHEET
ANTI-HYPERTENSIVES
PHARMACY
BETA-BLOCKERS
INSTRUCTIONS
DISPENSE
NOTES/INITIALS
ACE-INHIBITORS
CA-CHANNEL BLOCKERS
DIURETICS
ANTIBIOTICS
___________ mg capsules Take_______caps_______times a day, for ______days, for_______
Take_______ml(____mg)_______times a day, for ______days, for_______
Take_______tablets_______times a day, for ______days, for_______
Take_______ml(____mg)_______times a day, for ______days, for_______
___________ mg capsules Take_______caps_______times a day, for ______days, for_______
Take_______ml(____mg)_______times a day, for ______days, for_______
Take_______tablets_______times a day, for ______days, for_______
Take_______tablets_______times a day, for ______days, for_______
Take_______tablets_______times a day, for ______days, for_______
ASTHMA/ALLERGY/COLD
Take________spray to both nostrils_______times a day
______gtts to______eyes ______times a day
Take________tablets every_______hrs for_______
Take_______ml(____mg) every_______hrs for_______
Take________tablets every_______hours for congestion
Take_______ml(____mg) every_______hours for congestion
Put______drops in each nostril_____times a day for congestion
ADDITIONAL MEDS, PLEASE SEE ADDITIONAL PAGE: YES NO
If yes, this page ________of ________
PATIENT NAME: _______________________________________________DATE:_______________________
ORDERING PHYSICIAN: ______________________________________________________
PHARMACIST OR TECH NAME:_______________________________PHARMACY STUDENT(S): _____________________
__________________________________________
ALL MED ORDERS ON THIS PAGE HAVE BEEN FILLED: YES NO
FLYING SAMARITANS EL HONGO CLINIC
PHARMACY ORDER SHEET
PHARMACY
DIABETES
INSTRUCTIONS
DISPENSE
NOTES/INITIALS
PAIN/FEVER
Take________tablets every_______hours, for_______
Take________tablets every_______hours, for_______
Take________tablets every_______hours, for_______
Take_______ml(____mg) every______hrs, for_______
Take_______ml(____mg) every______hrs, for_______
Take_______ml(____mg) every______hrs, for_______
MISCELLANEOUS
Take________tablets_______times a day for constipation
Take one packet with juice, tea, coffe, water for constipation
Apply to affected areas ______times a day
Apply to affected areas ______times a day
Medication name/dosage
Instructions
Dispense Quantity
Special Instructions
PATIENT NAME: _______________________________________________DATE:_____________________
ORDERING PHYSICIAN: ______________________________________________________
PHARMACIST OR TECH NAME:______________________________PHARMACY STUDENT(S):
___________________________________________________________________________
ALL MED ORDERS ON THIS PAGE HAVE BEEN FILLED: YES NO
Source: http://flyingsamselhongo.com/pharmacyordersheet%20.pdf
I cannot stress enough the importance of keeping your cavy healthy rather than treating an ill one. Cavies require at least one square foot each of living space. Ideal room temperature is 65-75F. Ideal humidity is 40-70%. Cavies are very sensitive to heat and should not be kept in direct sunlight. Cavies should be kept draft free. Cages need to be kept clean as well as water bottles and feed dishe
Miss. Kannika Siripattarapravat Rewards: - A certificate of praise in good behavior child : Thai Buddhist Association under king’s patronage, Buddhist Observance in May, 1998. - Medals of praise in good grade student, annual scholastic award : Kasetsart University. - A medal of praise in first class honour: Kasetsart University, 2000. - A shield of praise in academic excel ence: Grad