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Patient Chart Date of Visit: 06/30/2019 Patients Name: Lee, Man DOB: 03/21/1960 Pt weight: 183.2 lbs Diagnosis: Low Testoste
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Patient's name: Lee, Man D.O.B:3/21/1960

Date:6/30/2019

Medication: Testosterone Cypionate Injection

Total quantity: 4.8 mg/kg/14 days (62.4 mg/kg/14 days for 6 months)

Instruction for administration:

- patient should inform about the allergy to any testosterone medication or any part of cypionate medication.

- sometimes the patient can have a very deadly sideeffects hence if such happens it should be informed to the physician immediately.

- to visit the physician exactly on the 6th month after taking the medication.

Prescribing physician: Music, Tor, DO

Refills: 5

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