RHAZES MEDICATION SLIP
Date
*
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Month
-
Day
Year
Date
Professional Healthcare Provider Email
*
example@example.com
Patient name / Nama Pesakit
Patient ID
Patient Email / Email Pesakit
*
example@example.com
Patient Mobile Phone Number / No Mobile Pesakit
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MEDICATION & DISEASE SUMMARY
List of Medication, Strength and Amount to be taken,Route by which it is to be taken & frequency / Senarai Medikasi, Dose dan Jumlah pengambilan & cara pengambilan ubat serta kekerapan
*
Disease (Diagnosis Penyakit)
*
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MEDICATION SLIP PREPARED BY
Title / Name / Designation / (Professional Healthcare Provider)
*
PROFESSIONAL REGISTRATION NUMBER
*
RHAZES TELEHEALTH INTERNATIONAL SDN BHD Website : www.rhazesconsult.com / Email : admin@rhazestelehealth.com / WhatsApp 013-393 8042
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