‘ANEXO
CODIGO DE
PRESTADOR
DIRECCION
515001140.
815001140,
815001140.
(815001140.
Biso0T 40] Cra 15 NP. 76-50
Biso0T 140 | Cra-15 NrP.26-50,
1001140 | Cra 15 Nr 26-50
i001 140 [Cra 15
#100140 [Cra 15 N
sre00T140_ [Cra 15 N
316001 140_| Cra 15 N
ErBo0T a0] ra 15 Nr 26-50 | 2505020,
SiBooT Tao [ra 15 Nre26-50
31001 40 Gra TS Nev 26-50
315001140_| ra 15 Nav 26:50
815001140] Cra 15 Na® 26:50
15001140_] Cra 15 Na* 26-50
(Cra 15 Nn®.26-50,
815001140.
Cra 15 Nn® 26-50,
815001140
815001140 _| Cra 15 Nn®.26-50
7815001140 | Cra 15 Nn®.26-50
815001140] Cra 15 Nn®.26-50
15001140__| Cra 15 Nn°.26-50
15001140_| Cra 15 Nn°.26-50.
815001140_| Cra 15 Nn°.26-50.
7815001140_| Cra 15 Nn®.26-50.
15007140 | Cra 15 Nn® 26-50
815001140 _| Cra 15 Nn® 26-50
1815001740.
(Cra 15 No®26-50.
815001140,
Cra 15 Nn®26-50.
815001140)
Cra 15 Nn® 26-50.
"815001140.
‘Cra 15 Nn®26-50
815001140
"815007140,
815001140.
‘815001140.
15001140
‘Cra 15 Nn®.26-50,
N= 2 CONTROL DE RECETARIOS OFICIALES DE MEDICAMENTOS DE SONTROL ESPECIAL
NOMBRE Y APELLIDO DEL
CamScanner
Powered bySo upTOEUENAN | GUO [OSSTAN GL CO] OOTIOOSTS [NOH
exo upy@etwewer | 9c0s6e7 | Ose aN Ste | OPLL00SIE | NOH a
‘oo obupymewuewan | ozoseez | 05-92 UN St BO] Ori tooste | NOH ze
am oBupy@evewer | ozoset2_[0s-92 uN Ste] ovis00ste_| NOH oe
aeoBupupewewer | ozoseee_[os-97 uN Ste | ort io0ste_[ NOH se
srobupiBeuewer | ocosece [os Se wn Ste | 0P1100ste_[ NOH a
L ‘co ob upy@emuewen | ozos6ec | 05-97 UN Si 81] Ori toosie | NOH te
4 asobupupeijuewer | Gzoseez [OSCAN St e-|ovtt0051e_[ NOH Fa
as oBupu@eiuewer | o7os6ez [OSC ANSI e* | ovri0051e_[ NOH i
asobupubevuewen | ozossez [Oe aN Ste] oF1t00518_[ NOH oF
esobupuBetueivar | pzossez [Ose N Sie | ovrs00ste_[ NOH [a
erovupu@erueier | ocossee [0eS2 aN Ste | orti00ste_[ NOH ra
esobupuBenaewer | ozosetz [os azn Ske | ovti00se_[ NOH ra
asabupuBeivewer | oeosetz loser an St ec | ovtvoosie [NOH 32
ssobupuBeivewer | ozoserz [0S92.N Ske | opti00s's_[ NOH sz
BeosEEe[0s-97 oN St 81D] OPLL00SLE [NOH 2
GensBee_[os-o7 uN St e0| OPiLo0ste_[ NOH a
Geossec_[os-Sz.0N St 8D] Orsiooste_[ NOH zz
sSapupeBeriveiver | ozoseez [Ose aN Ste | ovso0ste_[ NOH Tz
=xoBupyBeuvewer | oeosstz [sez an Ste ort yo0Ste_| NOH 02
soPupyBeiuewer | oeoseez [OseeaN-St e | ovr s00ste_[ NOH 31
“coobupy@emuewan | ozoseez | 0s-9z UN St eo] Obitoosie | NOH ab
H srobuRIDeueIer | ozossee [Fae aN Ste | oF1100s1_[ NOH i
erobupy@eruewen | ozoseez [oraz aN Ste] opss00s18_[ NOH ar
erebupuewewen | ozoseee[0s92 oN si eo | or1i00st@ | NOH st
exobupyeemuewen | ocossee [sez Nn st eD| orss00s18_| NOH +0
=xroBupy@envewer | czoseez [0s-97 uN ste | ovbioos1s_| NOH fer]
SrobupieruPweR | ocoseee_[osee aN Ste | orsso0ste_| NaH zr
saroBupuBenvewen | oz0s8ee_[os-o7 uN Ste] or4100s18_| NOH m
no aoroB upfDewUwIveN | ozos6E2 [05-07 uN St] or1100518 | NOH oF
srabuniDeiwvewer | ocoseee _[os-97 uN Ste; ovr vo0ste_[ NOH 6
ssoPunoeiunwen | ozoseee_[os-92 Jn ste | or1s00518_[ NOH 3
sroBupDeinvewen |_ozasece [os-a2 win Ste | oFL100510_[ NOH Z
: z aaoPupDeiuewen | ozasece [ose wn St ex [_orto0g19 | NOH °
ssebupIDeiENan | -ozossez [05-92 NST em | orL 100.8 _[ NOH $
sxobupa@enwewer | ozoseee [oss wiN'Sk e | orttons1e_[ NOH *
seobupi@enween | ozoseez [soe wn'St em | orsio0ste_| Now €
axobupi@enween | ozoseez [osez an st em | ovti00sie_[ NGH z
“oo ob upy@enuewer | zossez | 0592 UN St eID] OPI LOOSLE NOH L
‘WwNoISas0ud woavisaud ‘OAILNDaSNOD i woavisaud| (vawa) |
OULSIOSY ‘Tad OGITIad¥ A 3UEWON a ‘30 3143S Wa Jonosa7a4) NOID9a¥IA | aq op1a909 Sdl | yoga |)
TVI02aS9 TOUINO® 30 SOLNSNVOIGIM 34 SFTVIOLIO SORILB0RU 30 TOLLNOO ZN OXSNY
cunoua
Powered by CamScanner‘ GOBERNACION DEL VALLE DEL CAUCA
SECRETARIA DEPARTAMENTAL DE SALUD
FONDO ROTATORIO DE ESTUPEFACIENTES.
S 2 RECETARIO PARA MEDICAMENTOS DE CONTROL ESPECIAL
No. 2543833
7 PACIENTE Festa [Dia i ies OD ito DOLE
fi on Tas
gare Mine.
rt Tins Ci Sins
On Bee : = 4445085190 ceweater 26 r— [we
31452362794 Bega | Calle 2 # 711-2] eG.
Aacionni8388s [Bsuvaoss []eownuwe” or soa?
2 MEDICAMENTOS:
Nombre dea Endod Asoguradcra — EMSS
Nombre Genérico Concentracion | paiFSt@Sy. | Basis, Via de Administacion
L " armactutica_| precuencia de Adminstracl
Nidaztan Tomgts| LM | Smq in
Tempo dt Tatami. Lixacon ck Hibvo cago cre
3 PROFESIONAL ; =
$d ence Déjcenena _[ ]especiauzaoo | [ ]ovontovoco
Eepecned Oat
ies Apia Taunt pe T iene
‘arawl[o Cedano hone
Sacer te Ua ea ae is i
Pree o9 cur MSOF 525 x i
insitcin 2a Dission Gia H
Sse_ fos Tuna Wika C415 #IL- 50 Bog ieee
DEL (Par aiigenclarpor a cvibies ssa)
| Apetiidos y Nombres de quien recibe el Medicamento A
3
| potas y Wombres de quien despacha Wagon FIR ie
3
=
edicameatcs Dipeneados Cantidad Eregada wn Numeroe Conte Envgada on Laas fe
|
nos eras Mio a Pra as BS Tien [Fecha ae pace
bal Mest
Powered by CamScanner