02/16 1111 -.289288R • Prase.; pion no this supply 5 $ elix> CYPRUS Name and PBS approval number of pharmacist Issuing this atenciiisatIon PlIsdon Pharmacy Sala Irian listehmi B.Pharmacy 186 Balmoral Road Pail Pine SA 6540 Ph: 08 8633 4887 03/02/2016 CH 40676W Date this authorisation prepared re t