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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

 

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