Certificate Details Input

Prescription Details (Medicine Name Only)

BEFORE MEALS (e.g., Tab. Pantoprazole 40mg)
AFTER MEALS (e.g., Tab. Augmentin 625mg)

Clinic Contact/Address

Medical Certificate Preview

MISHRA DENTAL CLINIC

Smiles Designing, Teeth Whitening, Dental Implants, General Dentistry

DR. ASHUTOSH MISHRA | B.D.S., DENTAL & ORAL SURGEON

17 / 10 / 25

Name: Raj Chourasiya

Rx
Tab. Pantoprazole 40mg 1 - 0 - 1
Tab. Augmentin 625mg 0 - 1 - 1
Tab. Enzoflam SOS
Adv: Hexigel gum paint, 1-0-1 X 1 week
Ph: 07624292263 Leave: 4 days
Address: SEC 14, VASANTH MG, VIJAY NAGAR, DELHI

About this template

This template emulates a clean dental clinic prescription style with handwritten text rendering for realism. Use the fields to customize patient details, medications, and advice. The look is preserved via template-specific styles while the page uses the site’s shared header, navigation, disclaimer, and footer.

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