0 Prescription List Dr. Name: Patient Name: Departure Date: Patient Intake: SHIPPED FROM LAS VEGAS Potassium 100 GramsNone3 Mo./66 Mo./12 Lugol 5% Solution 2 ozNone3 Mo./46 Mo./8 Acidoll 450 MgNone3 Mo./66 Mo./11 Niacin 50 MgNone3 Mo./16 Mo./2 Thyroid 130 Mg (2Grain)None3 Mo./66 Mo./12 Liver Capsules 500 MgNone3 Mo./16 Mo./2 Pancreatin 1.2 MgNone3 Mo./26 Mo./4 TAKE HOME FROM HOSPITAL Vitamin B12 1ccNone3 Mo./26 Mo./4 Needle 25G X 1 (B12)None3 Mo./906 Mo./180 Syringe 3MLNone90 Syringe 1.0MLNone20 Coley's None1 Notes Vitamin C Grams: Vitamin C Week: Vitamin C Month: Vitamin K3 Mg.: Vitamin K3 Week: Vitamin K3 Month: Xeloda Mg: Xeloda Day: Xeloda Week: Xeloda Month: Jardianz Mg: Jardianz Per Day: Jardianz Month: Metformine Mg: Metformine Per Day: Metformine Month: DCA Mg: DCA Per Day: DCA Month: Vitamin B17 Gram: Vitamin B17 Week: Vitamin B17 Month: Thiamin Mg: Thiamin Per Day: Thiamin Month: Apatone Plus Bottles: Notes Additional Medications: