Kaiser Foundation Health Plan

350 St. Josephs Avenue, S.F., CA (415) 202 202-2161_ Refill: (415) 202-3795 Rx #512 80139 Dr. Jonathan Katz
DIAZEPAM 5MG Qty: 50 Tablets

Instructions: Take 1 tablet orally 2 times daily. May cause drowsiness. Alcohol ol may increase this drowsiness. Use care when operating a car or dangerous machinery.
Greene, Julie

Feb. 10, 1994 Discard after: 07/02

1. What street is the pharmacy located on? 2. Is the refill phone number the same as the regular phone number? 3. What is the physicians last name? 4. Should Julie take two tablets at the same time? 5. How many milligrams are in each tablet? 6. What is the expiration date of the medicine? 7. Is the medication still good? 8. Should the patient drink when she takes this medication? 9. When did the pharmacy fill the prescription?

10. How should the patient take this medicine? Choose a, b, or c. (See the pictures below.) (a) By suppository. ( , --She She puts it in her anus , ano, , ) (b) By injection. She gives herself a shot. (c) Orally. (She puts it in her mouth and swallows it.) (, tragar, , ) a b c

11. What is a side effect ( , efecto secundario, , ) of the medication? It can make you _______. ______

Kaiser Foundation Health Plan

350 St. Josephs Avenue, S.F., CA (415) 202 202-2161_ Refill: (415) 202-3795 Rx #512 80139 Dr. Jonathan Katz
DIAZEPAM 5MG Qty: 50 Tablets

Instructions: Take 1 tablet orally 2 times daily. May cause drowsiness. Alcohol ol may increase this drowsiness. Use care when operating a car or dangerous machinery.
Greene, Julie

Feb. 10, 1994 Discard after: 07/02

1. What street is the pharmacy located on? 2. Is the refill phone number the same as the regular phone number? 3. What is the physicians last name? 4. Should Julie take two tablets at the same time? 5. How many milligrams are in each tablet? 6. What is the expiration date of the medicine? 7. Is the medication still good? 8. Should the patient drink when she takes this medication? 9. When did the pharmacy fill the prescription?

10. How should the patient take this medicine? Choose a, b, or c. (See the pictures below.) (a) By suppository. ( , --She She puts it in her anus , ano, , ) (b) By injection. She gives herself a shot. (c) Orally. (She puts it in her mouth and swallows it.) (, tragar, , ) a b c

11. What is a side effect ( , efecto secundario, , ) of the medication? It can make you _______. ______
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