Dispense Drug and Billing
Patient Name
Pharmacy Bill No.
Total Amount
#
Drug Name
Formulation
Dose
Frequency
Days
Qty
1
Amoxicillin 500mg Capsule
Capsule
1
3x daily
5
15
Start Date:
End Date:
Notes:
Take after meals with water.
2
Ibuprofen 400mg Tablet
Tablet
1
2x daily
3
6
Start Date:
End Date:
Notes:
Take with food to prevent stomach irritation.
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Billing Summary
#
Drug Name
Qty
Rate
Amount
Total:
GH¢ 0.00
Amount Paid:
GH¢ 0.00
Amount Due:
GH¢ 0.00
Status: Paid