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Get Borang Ubat Melalui Pos

50 kawasan Putrajaya / RM 5. 00 semenanjung Malaysia / RM 8. 00 Sabah Sarawak sebaik sahaja serahan ubat diterima melalui Pos Laju. / Tandatangan pesakit Jika berkaitan Tarikh Pesanan diambil melalui telefon pada UNTUK KEGUNAAN JABATAN FARMASI HPJ PENGESAHAN PENERIMAAN PESANAN UMP 1Malaysia 1 PENGESAHAN PENERIMAAN PESANAN PHDP Nama Pegawai Farmasi Tarikh menerima pesanan PHDP 2 MAKLUMAT PRESKRIPSI PESAKIT Tarikh preskripsi Tarikh temujanji pesakit berjumpa Dr. Borang Perkhidmatan Ubat Melalui Pos 1Malaysia No rujukan UMP HPJ No* item PosLaju E Nama Pesakit No* Kad Pengenalan No* MRN Alamat Penghantaran Ubat M Y Rumah Pejabat Telefon Bimbit Poskod Negeri No* Telefon untuk dihubungi E mail Maklumat Tambahan / Nota Pesanan Dengan ini saya berjanji akan membuat bayaran perkhidmatan bagi pengeposan ubat ubatan ke alamat di atas sebanyak RM 3. 50 kawasan Putrajaya / RM 5. 00 semenanjung Malaysia / RM 8. 00 Sabah Sarawak sebaik sahaja serahan ubat diterima melalui Pos Laju. / Tandatangan pesakit Jika berkaitan Tarikh Pesanan diambil melalui telefon pada UNTUK KEGUNAAN JABATAN FARMASI HPJ PENGESAHAN PENERIMAAN PESANAN UMP 1Malaysia 1 PENGESAHAN PENERIMAAN PESANAN PHDP Nama Pegawai Farmasi Tarikh menerima pesanan PHDP 2 MAKLUMAT PRESKRIPSI PESAKIT Tarikh preskripsi Tarikh temujanji pesakit berjumpa Dr. Tempoh bekalan ubat pertama Tarikh bekalan ubat seterusnya 2nd bulan SOC Jumlah ubat dibekalkan kali pertama item Jumlah ubat dipos Hubungi semula pesakit untuk persetujuan penghantaran bekalan partial seterusnya* Pesakit setuju / tidak setuju Sebarang pertanyaan sila hubungi Pegawai Farmasi Farmasi Klinik Pakar di talian 03 83124247/4269 atau e mail permohonan/pertanyaan ke alamat email pharmacypost hpj. Borang Perkhidmatan Ubat Melalui Pos 1Malaysia No rujukan UMP HPJ No* item PosLaju E Nama Pesakit No* Kad Pengenalan No* MRN Alamat Penghantaran Ubat M Y Rumah Pejabat Telefon Bimbit Poskod Negeri No* Telefon untuk dihubungi E mail Maklumat Tambahan / Nota Pesanan Dengan ini saya berjanji akan membuat bayaran perkhidmatan bagi pengeposan ubat ubatan ke alamat di atas sebanyak RM 3. 50 kawasan Putrajaya / RM 5. 00 semenanjung Malaysia / RM 8. 00 Sabah Sarawak sebaik sahaja serahan ubat diterima melalui Pos Laju. / Tandatangan pesakit Jika berkaitan Tarikh Pesanan diambil melalui telefon pada UNTUK KEGUNAAN JABATAN FARMASI HPJ PENGESAHAN PENERIMAAN PESANAN UMP 1Malaysia 1 PENGESAHAN PENERIMAAN PESANAN PHDP Nama Pegawai Farmasi Tarikh menerima pesanan PHDP 2 MAKLUMAT PRESKRIPSI PESAKIT Tarikh preskripsi Tarikh temujanji pesakit berjumpa Dr. Tempoh bekalan ubat pertama Tarikh bekalan ubat seterusnya 2nd bulan SOC Jumlah ubat dibekalkan kali pertama item Jumlah ubat dipos Hubungi semula pesakit untuk persetujuan penghantaran bekalan partial seterusnya* Pesakit setuju / tidak setuju Sebarang pertanyaan sila hubungi Pegawai Farmasi Farmasi Klinik Pakar di talian 03 83124247/4269 atau e mail permohonan/pertanyaan ke alamat email pharmacypost hpj.

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