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EFTA00265337
If erri ral not supplied Otlly No. of repeats authorised. 8/1W2015 11-N276791 5 bt• andQVC 13J3CPPI89 Name PBS approval number of pharmacist Ispensing this suppy id to: 08/10(16 pharmacist if needed before: 29/02/18 Presc ipton no this supply 6 DOVES$ r j Name and PBS approval number of phar
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