Sample Medication Log - Princeton Insurance
Sample Medication Log - Princeton Insurance
Sample Medication Log - Princeton Insurance
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<strong>Sample</strong> <strong>Medication</strong> <strong>Log</strong><br />
RECEIVED<br />
Pharmaceutical Co. /<br />
Manufacturer<br />
<strong>Medication</strong><br />
Dose /<br />
Strength<br />
Lot #<br />
Exp. Date<br />
Quantity<br />
Received<br />
Date<br />
Received<br />
Initials
<strong>Sample</strong> <strong>Medication</strong> <strong>Log</strong><br />
DISPENSED<br />
Patient’s Name<br />
Dispensing<br />
Practitioner’s<br />
Name<br />
Pharmaceutical<br />
Co. /<br />
Manufacturer<br />
<strong>Medication</strong><br />
Dose /<br />
Strength<br />
Lot #<br />
Exp.<br />
Date<br />
Quantity Date<br />
Dispensed Dispensed Initials
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