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Physician:_______________________________ City____________________ State____ Zip_______ Okatie, SC 29936 Phone_________________ Fax________________ Phone: (888)-322-6641
FAX: (843)-645-9987
Patient Name: ______________________________ Date: ___________________
Address: ___________________________________ City: ____________________ State: _______ Zip Code: _______
Date of Birth: _______________________________ Allergies: ________________
Telephone Number: _________________________
Nausea/Vomiting/Agitation
 Lorazepam 1 mg/mL/Diphenhydramine 12.5 mg/mL/Haloperidol  Ondansetron 4 mg/0.1 mL Topical Lipoderm Ginger Root 200 mg capsules  ABHR (Lorazepam/Diphenhydramine/Haldol/Metoclopromide) Lorazepam gel (1mg/ml) Sig: _____________________________________________________________________________________ Quantity: _________ ________________________________________________________________________________________________________________________________
Dry Mouth
 Sodium Cl 8.8 mg/Potassium Cl 3.1 mg/Calcium Cl 3.4 mg Base A Troche Sig: ________________________________________________________________________________________ ________________________________________________________________________________________________________________________________
Mouth Pain

 Misoprostol 0.0024%/Diphengydramine HCl 0.1%/Compound Oral Rinse  Morphine Sulfate 1 mg/mL Oral Gel Diphenhydramine HCl 25 mg/Lidocaine HCl 2%/Hydrocortisone 1%  Magic Mouthwash (Tetracycline/Diphenhydramine/Lidocaine/Maalox)* *( You can customize your own mouthwash) Sig: _____________________________________________________________________________________ Quantity: _________ ________________________________________________________________________________________________________________________________
Pain Managment
 Ketoprofen 10% Topical Lipoderm
 Ketamine 10%/Gabapentin 6%/Clonidine 0.2%/Nifedipine 2% Topical Lipoderm  Diclofenac Sodium 10% Lipoderm Transdermal Gel  Ketamine 10%/Gabapentin 6%/Clonidine 0.2%/Nifedipine 2% Topical Lipoderm* *(Ideal for Neuropathic pain) Sig: _____________________________________________________________________________________ Quantity: _________ ________________________________________________________________________________________________________________________________
Wound Care Managment
 Phenytoin 5%/Misoprostol 0.0024% Topical Gel
 Phenytoin 2%/Misoprostol 0.0024%/Lidocaine 2%/Bupivacaine 0.2%/Diphenhydramine  Ketoprofen 2%/Lidocaine 2%/Misoprostol 0.0024%/Phenytoin 2%/Aloe Vera 0.2%  Misoprostol 0.0024%/Phenytoin 5%/Metronidazole 2% Topical Gel Sig: _____________________________________________________________________________________ Quantity: _________ ________________________________________________________________________________________________________________________________
Physician Signature: ____________________________

Source: http://www.lowcountryrx.com/wp-content/uploads/2010/10/NauseaPainWound.pdf

Microsoft word - purim fundraiser letter.2014

Chabad of Bradenton & Lakewood Ranch This year more people will experience the joy of Purim! Purim is one of the most joyous and fun holidays on the Jewish calendar. On Purim, we emphasize the importance of Jewish unity and friendship by sending gifts of food to friends and family. This Purim mitzvah is called Mishloach Manot. This year Chabad is sponsoring shared Mishloach Manot gift boxes

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Sifton Bog White-tailed Deer Issue Steering Committee Meeting Notes Tuesday, July 10, 2001, Riverside United Church Committee member attendance: Barry UTRCA, City of London and Ontario Ministry of Natural Resources Representatives: Joe DeLaronde Welcome & Introductions The members of the committee introduced themselves. Teresa explained that the meeting would beinformal and that

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