NUTRITIONAL PRESCRIPTION

Name: Amber Compounding Pharmacy
Address: 221 South Bridge Road, SINGAPORE, 058770
Price range: Custom

Patient Details:
Name of Patient:: Name of Patient
First Name:

Last Name:
IC/Passport Number:
Date of Birth:
Contact Number:
Address:: Line 1:

Line 2:

City:

Country:

Singapore

State:

Postal Code:
Prescription Details:
Preferred Dosage:: PowderCapsules
Preferred Dosage
Vegetarian:: YesNo
Vegetarian
Duration of Supply:
Number of Repeats:
:: All does expressed in Elemental Values
Ingredients:: Alpha Lipoic Acid (mg)Ascorbic acid [Vitamin C] (mg)Beta Carotene (IU)Biotin (mcg)Calcium (mg) as CarbonateCalcium (mg) as CitrateChromium (mcg) as PicolinateCoenzyme Q10 (mg)Copper (mg) as GluconateFolic acid (mcg)
Spam Verification:

Phone: (+65) 6338 6867

Fax: (+65) 6338 6360

ABN: UEN 200804539C

Address: 221 South Bridge Road, Singapore, Singapore, 058770

Designed by Bloomtools

All does expressed in Elemental Values