Judetul ____________________ GALATI Localitatea ____________________ CABINET MEDICAL DR. PROFIR ANCA Unitatea sanitara ________________________________ SRL
SION Nume _______________________________________ MARGARETA Prenume _____________________________________ 68 ani 2048 Sex M/F, Varsta ______ ani, Nr. RC/FO _________ DOMICILIU GALATI GALATI Judetul __________ Localitatea___________________ GH. ASACHI 3 Strada _____________________________ Nr _______ DIAGNOSTIC _____________________________________________ 606 ALTE FORME DE URTICARIE _____________________________________________ _____________________________________________ _____________________________________________ RP. TRIDERM 1-0-1 UNGUENT 0,5mg+10mg+1mg 1(unu) _____________________________________________ /g
