PRESCRIPTION
Ref: D4U-RX-0421
Date: 14 Oct 2026
Patient
Laura Benson
DOB: 2 Nov 1979 (age 46)
5 Elm Grove, London
N8 9AB
07700 900456
Clinic
The Face Clinic — Harley St
Medical conditions / medication
Hypothyroidism — levothyroxine 50mcg.
| Rx | Product | Description | Qty |
|---|---|---|---|
| 1 | Azzalure 125 units | Forehead & crow's feet | 1 |
| 2 | Hyalase 1500 IU | Emergency kit | 1 |
Derma4U Ltd · www.derma4u.co.uk · This prescription is valid for 28 days from the date of issue.