Binh Thuan Medical Service

Dr.DONGS 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 :
1Dexamethason 4mg
X
05
Bottles/ Ampules/ Tablets/ Packets/
Creame
Morning1.5 amp.Afternoon.Evening
1amp
( 2
days )
InjectionIM

Drinking/ To apply (.minutes before meal/minutes

after meal
2Cetirizin
10 mg
X
05
Bottles/ Ampules/ Tablets/
Packets/ Creame
Morning1 tab.Afternoon.Evening
( 5
days)
Injection

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

after meal)
3Prednisolon 5mg
X 20 Bottles/ Ampules/ Tablets/ Packets/
Creame
Morning 2 tabs .Afternoon2tabs Evening .
( 5
days )
Injection

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

after meal)
4.Biafine .... X
1 Bottles/ Ampules/ Tablets/ Packets/ Creame
Morning1 time.Afternoon1 timeEvening1 time
( 7
days)
Injection Drinking/ To apply (.minutes before meal/minutes after
meal)
5Vitamin C 1gr
X 1 tube Bottles/ Ampules/ Tablets/ Packets/
Creame
Morning 1 tab .Afternoon1 tab Evening .
( 5
days )
Injection

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

after meal)

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

Avoid strong sunlight for at least 5 days

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