Imss 3a1z5a
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NSS:XXXXXXXXXX
AGREGADO. MED.: 1M1995OR NOMBRE DEL PACIENTE
XXXXXXXXXXXXXXXXXXXXXXXXXXXX CURP: XXXXXXXXXXXXXXX SEXO: -------------------DELEGACION: -------UNIDAD: UMF NO.xx CONSULTORIO: ---
CVE.PTAL.XXXXXXXXXXXX TURNO: MATUTINO
183050361058XH
Fecha: xxxx, xx de xxxx de 20xx
8257 DICLOXACILINA, CAPSULA. CADA CAPSULA CONTIENE: DICLOXACILINA 500 MG . Un (a) capsula (s) cada 6 hora (s) durante 9 día (s)
6478 CLORANFENICOL, GOTAS. CADA GOTAS CONTIENE: CLORANFENICOL 5 MG/ML. Un (a) gota (s) cada 4 hora (s) durante 6 día (s)
Nombre y firma del médico
Cédula Profesional
Edgar Rubén Palomares Guzmán
3662285
Matricula
99317735
PACIENTE
AGREGADO. MED.: 1M1995OR NOMBRE DEL PACIENTE
XXXXXXXXXXXXXXXXXXXXXXXXXXXX CURP: XXXXXXXXXXXXXXX SEXO: -------------------DELEGACION: -------UNIDAD: UMF NO.xx CONSULTORIO: ---
CVE.PTAL.XXXXXXXXXXXX TURNO: MATUTINO
183050361058XH
Fecha: xxxx, xx de xxxx de 20xx
8257 DICLOXACILINA, CAPSULA. CADA CAPSULA CONTIENE: DICLOXACILINA 500 MG . Un (a) capsula (s) cada 6 hora (s) durante 9 día (s)
6478 CLORANFENICOL, GOTAS. CADA GOTAS CONTIENE: CLORANFENICOL 5 MG/ML. Un (a) gota (s) cada 4 hora (s) durante 6 día (s)
Nombre y firma del médico
Cédula Profesional
Edgar Rubén Palomares Guzmán
3662285
Matricula
99317735
PACIENTE
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