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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 pesa....

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How to fill out the Borang Ubat Melalui Pos online

Completing the Borang Ubat Melalui Pos online can streamline the process of receiving medications at your preferred address. This guide will provide clear instructions on how to accurately fill out each section of the form.

Follow the steps to successfully complete your form online.

  1. Press the ‘Get Form’ button to access the form. This will allow you to open the document in the editor.
  2. Enter the patient's name in the designated field labeled 'Nama Pesakit.' Ensure accurate spelling to avoid any delays in processing.
  3. Fill in the patient's identification number under 'No. Kad Pengenalan.' This information is crucial for identification purposes.
  4. Provide the Medical Record Number (MRN) in the relevant section. If this information is unavailable, it may be left blank.
  5. In the 'Alamat Penghantaran Ubat' section, enter the complete delivery address for medication. Include house, office, or cellular phone numbers as required.
  6. Specify the state and postal code in the appropriate fields to ensure accurate delivery.
  7. Enter a contact number under 'No. Telefon untuk dihubungi,' allowing relevant personnel to reach the patient if needed.
  8. Provide an email address for additional communication regarding the medication delivery.
  9. Include any additional information or notes in the 'Maklumat Tambahan / Nota Pesanan' section to convey special instructions.
  10. Acknowledge the payment responsibility for the service by making a note of the amount applicable for your location next to the corresponding fee.
  11. Sign where indicated under 'Tandatangan pesakit,' and input the date of signing in the documentation.
  12. Review all entered information for accuracy before finalizing the completion of the form.
  13. Once completed, you can save your changes, download the form, print it for your records, or share it as required.

Complete your Borang Ubat Melalui Pos online to facilitate your medication delivery process.

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