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White and Red Label - Pharmacy

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____________ Drugstore & Gen. Merchandise ____________ Drugstore & Gen. Merchandise ____________ Drugstore & Gen.

Merchandise
#111 Purok 3, ____________, ____________, Laguna #111 Purok 3, ____________, ____________, Laguna #111 Purok 3, ____________, ____________, Laguna

Rx Date Rx Date Rx Date

Generic Name Generic Name Generic Name

Brand Name Brand Name Brand Name

Manufacturer Manufacturer Manufacturer

Dosage Strength Dosage Strength Dosage Strength

Expiry Date Expiry Date Expiry Date

Lot.No. Lot.No. Lot.No.

Direction For Use Direction For Use Direction For Use

Pharmacist Pharmacist Pharmacist

Patient Patient Patient

____________ Drugstore & Gen. Merchandise ____________ Drugstore & Gen. Merchandise ____________ Drugstore & Gen. Merchandise
#111 Purok 3, ____________, ____________, Laguna #111 Purok 3, ____________, ____________, Laguna #111 Purok 3, ____________, ____________, Laguna

Rx Date Rx Date Rx Date

Generic Name Generic Name Generic Name

Brand Name Brand Name Brand Name

Manufacturer Manufacturer Manufacturer

Dosage Strength Dosage Strength Dosage Strength

Expiry Date Expiry Date Expiry Date

Lot.No. Lot.No. Lot.No.

Direction For Use Direction For Use Direction For Use

Pharmacist Pharmacist Pharmacist

Patient Patient Patient

____________ Drugstore & Gen. Merchandise ____________ Drugstore & Gen. Merchandise ____________ Drugstore & Gen. Merchandise
#111 Purok 3, ____________, ____________, Laguna #111 Purok 3, ____________, ____________, Laguna #111 Purok 3, ____________, ____________, Laguna

Rx Date Rx Date Rx Date

Generic Name Generic Name Generic Name

Brand Name Brand Name Brand Name

Manufacturer Manufacturer Manufacturer

Dosage Strength Dosage Strength Dosage Strength

Expiry Date Expiry Date Expiry Date

Lot.No. Lot.No. Lot.No.

Direction For Use Direction For Use Direction For Use

Pharmacist Pharmacist Pharmacist

Patient Patient Patient

____________ Drugstore & Gen. Merchandise ____________ Drugstore & Gen. Merchandise ____________ Drugstore & Gen. Merchandise
#111 Purok 3, ____________, ____________, Laguna #111 Purok 3, ____________, ____________, Laguna #111 Purok 3, ____________, ____________, Laguna

Rx Date Rx Date Rx Date

Generic Name Generic Name Generic Name

Brand Name Brand Name Brand Name

Manufacturer Manufacturer Manufacturer

Dosage Strength Dosage Strength Dosage Strength

Expiry Date Expiry Date Expiry Date

Lot.No. Lot.No. Lot.No.

Direction For Use Direction For Use Direction For Use

Pharmacist Pharmacist Pharmacist


Patient Patient Patient
____________ Drugstore & Gen. Merchandise ____________ Drugstore & Gen. Merchandise ____________ Drugstore & Gen. Merchandise
#111 Purok 3, ____________, ____________, Laguna #111 Purok 3, ____________, ____________, Laguna #111 Purok 3, ____________, ____________, Laguna

Rx Date: ________________ Rx Date: ________________ Rx Date: ________________

EXTERNAL USE EXTERNAL USE EXTERNAL USE

____________ Drugstore & Gen. Merchandise ____________ Drugstore & Gen. Merchandise ____________ Drugstore & Gen. Merchandise
#111 Purok 3, ____________, ____________, Laguna #111 Purok 3, ____________, ____________, Laguna #111 Purok 3, ____________, ____________, Laguna

Rx Date: ________________ Rx Date: ________________ Rx Date: ________________

EXTERNAL USE EXTERNAL USE EXTERNAL USE

____________ Drugstore & Gen. Merchandise ____________ Drugstore & Gen. Merchandise ____________ Drugstore & Gen. Merchandise
#111 Purok 3, ____________, ____________, Laguna #111 Purok 3, ____________, ____________, Laguna #111 Purok 3, ____________, ____________, Laguna

Rx Date: ________________ Rx Date: ________________ Rx Date: ________________

EXTERNAL USE EXTERNAL USE EXTERNAL USE

____________ Drugstore & Gen. Merchandise ____________ Drugstore & Gen. Merchandise ____________ Drugstore & Gen. Merchandise
#111 Purok 3, ____________, ____________, Laguna #111 Purok 3, ____________, ____________, Laguna #111 Purok 3, ____________, ____________, Laguna

Rx Date: ________________ Rx Date: ________________ Rx Date: ________________

EXTERNAL USE EXTERNAL USE EXTERNAL USE

____________ Drugstore & Gen. Merchandise ____________ Drugstore & Gen. Merchandise ____________ Drugstore & Gen. Merchandise
#111 Purok 3, ____________, ____________, Laguna #111 Purok 3, ____________, ____________, Laguna #111 Purok 3, ____________, ____________, Laguna

Rx Date: ________________ Rx Date: ________________ Rx Date: ________________

EXTERNAL USE EXTERNAL USE EXTERNAL USE

____________ Drugstore & Gen. Merchandise ____________ Drugstore & Gen. Merchandise ____________ Drugstore & Gen. Merchandise
#111 Purok 3, ____________, ____________, Laguna #111 Purok 3, ____________, ____________, Laguna #111 Purok 3, ____________, ____________, Laguna

Rx Date: ________________ Rx Date: ________________ Rx Date: ________________

EXTERNAL USE EXTERNAL USE EXTERNAL USE

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