HEALTH CARE PROVIDER ORDER Health Care Provider Findings Continue current medications Medication/Treatment Orders Ultram 50mg by mouth three times daily √ Luminal 97.2mg by mouth daily in the evening √ Instructions Follow-up visit Lab work or Tests Signature Date 2-1-yr Dr. Richard Black
Health Care Provider Findings Continue current medications Medication/Treatment Orders √ Ultram 50mg by mouth three times daily √ Luminal 97.2mg by mouth daily in the evening Instructions Follow-up visit Lab work or Tests Signature Dr. Richard Black Date 2-1-yr HEALTH CARE PROVIDER ORDER