Translated from: Date:

Spanish 20 September 2023

MEDICAL REPORT

Date of issue: 13-09-2023

To verify this prescription, scan the QR code

or go to
https://verificar.simplehealth.cl/receta and
use the folio number 9327751134.

Patient’s name: Catherine Sánchez Díaz

ID (RUN) No.: 18.526.225-1
Age: 29 years old

Active ingredient (D.C.I.): Lamotrigine 100 mg, tablets

Indications: Two tablets every day
Beginning of treatment: 13-09-2023
End of treatment: 13-09-2024
Total: 12 months
Other indications: Lamotrigine 100 mg, 2-0-0 (permanent)

Physician’s name: Dra. Josefina Carrera Schisano

ID (RUN) No.: 19.335.723-7
Specialization: General Physician
Address: Av. Apoquindo 6410, office 605, La Condes, RM.
Phone number: +56 9 3911 5286
SIS Registry: 725613
Physician’s name: Dra. Josefina Carrera Schisano

Digitally signed by
JOSEFINA IGNACIA CARRERA SCHISANO
ID (RUN) No. 19335723-7 on 13-09-1023.
Valid from 28-10-2022
To 28-10-2023

Verify Signature at https://asistencia.acepta.com/buscar-certificado.html using the Signer's RUT and Certificate

Serial Number.

Document Incorporates Electronic Signature according to Act No. 19.799. Printed Document is only a copy of
the Original Document.

This is a true and correct translation of the attached document, submitted to me in Spanish. To the best of my knowledge
and belief, I hold accreditation as a translator that the statements in the English language in the attached translation have
the same meanings as those in the Spanish language in the original document.

Siria Rosales Rodríguez, Accredited Translator from Spanish into English

English/Spanish/English Professional Translator from Universidad de La Serena
Address: Padre Alonso de Ovalle 868, apartment 801-A, Santiago Centro, Santiago, Chile
Phone: +56 9 93382671; siriarosalestraductora@gmail.com
ID (RUN) No.: 16.075.063-4