PRESCRIPTION FORM:

Bacterium regimen for urinary tract infection of patient daily,Irene Phyllis on 06/30/2019.
Date of Visit: 06/30/2019 Patient Chart DOB: 05/31/1955 Patient's Name: Daily, Irene Phyllis Pt weight: 156...
Potient Chart Date of Visit: 06/30/2019 Patient's Name: Daily, Irene Phyllis DOB: 05/31/1955 Diagnosis: Urinary Tract Infection Pt weight: 156 lbs Treatment plan: Bactrim regimen Medications prescribed, including dosing information and frequency: 40 mg/kg/day divided twice daily for ten days Route of administration: oral, 200/40/5 ml suspension, no tablets Treating Physician: Mydoc Tor, DO Prescription from Generic Medical Associates, LLC Patient's Name Date: Medication: Total Quantity Instructions for administration: Prescribing Physician Refills:
Patient Chart Date of Visit: 06/30/2019 Patient's Name: Lee, Man DOB: 03/21/1960 Pt weight: 183.2 lbs Diagnosis: Low Testosterone levels Treatment plan: Injectible testosterone Medications prescribed, including dosing information and frequency Testosterone Cypionate injection, 4.8 mg/kg/14 days, once biweekly, follow up visit in 6 months, 5 refills Route of administration: intramuscular, 30 mg/1.5mL suspension Treating Physician: Mydoc Tor, DO Prescription from Generic Medical Associates, LLC Patient's Name: DOB: Date: Medication: Total Quantity: Instructions for administration: Prescribing Physician: Refills: