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Ordinary

Prescription/IDnumber:

DANGYANGURBANANDRURALRESIDENTBASICMEDICALINSURANCE

SPECIFICPRESCRIPTIONFORM

Name:panda Sex:female  Age:41                   Ordinaryclinic: Chronicdisease:

Di**nosis: Parkinson’sdisease                     CooperationInsurancecardNo.:

R

PramipexoleDihydrochlorideTablets:1mg*270

Sig:1mgP.O.TID.

Validonlydueday

Physician:XUAN’GUO                            Dec.18,2019

Westernmedicine

Chinesemedicine

Disposal

Check

Total

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