Binh Thuan Medical Service

Dr.DONGS Polyclinic

Phan Thiet, Date.....01...../...12......../...2011..................

Name of the subscriber (patient):

GAGARINSKII DENIS...........
Date of brith:
31.05.1995.....- Sex: Male
Address:
Terracotta Resort, Phan Thiet, Viet Nam..........- Room: 608
Diagnosis :
Acute Viral Infection
TREATMENT
Drugs :
1Ringer Lactate
X 1000 ml
Bottles/ Ampules/ Tablets/ Packets/
Creame
Morning.AfternoonEvening
InjectionIV Drinking/ To apply (.minutes before meal/minutes after
meal)
2Glucose 10 %
X 500 ml Bottles/ Ampules/ Tablets/ Packets/ Creame
Morning.Afternoon
Evening
InjectionIV Drinking/ To apply (.minutes before meal/minutes after
meal)
3Dextrose natri X 500 ml Bottles/ Ampules/ Tablets/ Packets/ Creame
Morning.AfternoonEvening
InjectionIV Drinking/ To apply (.minutes before meal/minutes after
meal)
4Laroscorbin .1 gr X 1 Bottles/ Ampule/ Tablets/ Packets/ Creame
Morning1 amp.Afternoon.Evening
InjectionIV Drinking/ To apply (.minutes before meal/minutes after
meal)
5Bidizyme . X 1 Bottles/ Ampule/ Tablets/ Packets/ Creame
Morning1 amp.AfternoonEvening
Injection Drinking/ To apply (.minutes before meal/minutes after
meal)
6Efferalgan 500mg X 10 Bottles/ Ampules/ Tablets/ Packets/ Creame
Morning1tabAfternoon1tab.Evening 1tab
( > = 380 C )
Injection

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

meal)
7Vinaho. X 2 Bottles/ Ampules/ Tablets/ Packets/ Creame
Morning1 packet.Afternoon1 packetEvening
( 2 days )
InjectionSpray Drinking/ To apply (.minutes before meal/minutes
after meal)
8Vitamin C 1 g.. ..
X
1 tube Bottle/ Ampules/ Tablets/ Packets/
Creame
Morning.1 tablet.Afternoon1tabletEvening.
Injection Drinking/ To apply (.,minutes before meal/.30minutes after meal)

9Multivitamin.. ..
X
1 tube Bottle/ Ampules/ Tablets/ Packets/
Creame
Morning.1 tablet.Afternoon1tabletEvening.
Injection Drinking/ To apply (.,minutes before meal/.30minutes after meal)

Instrutions : - Only soup for today and tomorrow .

Doctors Signature:

Add: 29A Nguyen inh Chieu- Ham Tien ward - Phan Thiet City - Binh Thuan
Province - VIET NAM
Tel/ Fax : (+84)62 3741213
Mobile :
(+84) 918210504 - Email :
dr.vohongdongbt@yahoo.com.vn