Medication Request. WESTHOUGHTON.

Surname
E-mail
Name of your pet
Pet's reference no. (on drug label)
Address
Name of FIRST medication
Size of tablet/bottle/tube (see label)
Dose (e.g. 1 every 12 hours)
number of tabets/bottles requested
Name of SECOND medication
Size of tablet/bottle/tube
Dose
number of tablets/bottles requested
Name of THIRD medication
Size of tablet/bottle/tube
Dose
number of tablets/bottles requested
Comments relevant to this request.