Page 7 - Liver patient passport
P. 7

Please use the table below to list ALL of the
       medications you are taking. These include both
       prescription and non-prescription.

 Pharmacy name and address:


 Medication  Condition   When do I take it?  Start   Stop
 Name  Dose  I take it for  Morning  Noon  Evening  Bed  date  date  Doctor  Special instructions

       Non-prescription medicines: (also known as ‘over-the-counter’ medicines) – medicines
       that you can buy without a prescription from your doctor. These include vitamins, herbal
       medications, pain relief medications, dietary supplements and cough and cold medications.

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