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FORMATO PARA EL CONTROL DE MEDICAMENTOS NARCOTICOS Y

PSICOTROPICOS

NOMBRE DEL PACIENTE:_________________________________________________________CAMA _________________


EDAD ________________________________ SEXO_____________ SERVICIO :___________________________________

MEDICAMENTO:______________________________________________________________________________________

VIA:____________________________ DOSIS: _______________________ FECHA: _______________________________

MEDICO QUE SUBCRIBE: _____________________________________________________________________________


ENFERMERA QUE ADMINISTRA:________________________________________________________________________
JEFA DE SERVICIO:
________________________________________________________________________________________________________

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