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APPENDIX 3: MEDICATION ASSESSMENT TOOLS
APPENDIX 8
MEDICATION HISTORY ASSESSMENT FORM CP 1
PHARMACY DEPARTMENT,HOSPITAL…………………………………………………………………….
FORM TO BE FILLED BY THE PHARMACIST UPON PATIENT ADMISSION
Pharmacist Sign & Stamp: _________________________________ Time / Date: ________________________
Original : To be kept in patient’s folder
Duplicate : To be kept by Pharmacy
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