Client Details


Client Name                 Mrs A Petowner
Client Address           Dachshund Cottage, Persian Road
(inc Postcode)            Kenilworth, Warwickshire, D09 M3W
Client Telephone No     09812 789435

Animal Details

Name                      Stretch
Breed                      Bassett Hound
ID, if used
Weight, if known       approx  31          Kgs

 Medicine Details

Brand Name, Strength & Formulation (Enter Below)
Woomph Hearty 50mg tablets
Quantity of tablets to be supplied        28 tablets
Route of Administration        to be given orally
Dosage instructions      1 tablet to be given twice a day with food
Number of Prescription Repeats      Repeat on 3 occasions

 Presriber Details

Name                 Mr V Surgeon  Qualifications      MRCVS
Name of Practice       The Veterinary Practice
Address                      Dog Kennel Lane, Woofferton, Shropshire
Signature            V Surgeon                          Date      23/12/2005
I declare that this prescription is for an animal under my care



PRESCRIPTION IS VALID FOR 6 MONTHS FROM
PRESCRIBING DATE

FAX COMPLETED PRESCRIPTIONS TO 01777 710541