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STARTER CHECKLIST PAGE 1 Rev 4/2020 Home___ MEDICATION GENERIC NAME # IN KIT MED QTY ANTIBIOTIC SOLIDS 250mgamoxicillin28Ampicillin 500mgampicillin18Augmentin 250mgamoxicillin/clavulanate16Augmentin
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The wwwtemplatenetmedication-checklist-templates10 medication checklist templatessamples is a template used to keep track of medications.
Patients or caregivers responsible for managing medication schedules are required to fill out the template.
The template should be filled out by entering the name of the medication, dosage, frequency, and any special instructions.
The purpose of the template is to ensure that medications are taken correctly and to keep track of any changes in medication schedules.
Information such as the name of the medication, dosage, frequency of administration, and any special instructions must be reported on the template.
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