prescription form

Name/Title

prescription form

Entry/Object ID

ACS-002002

Description

Form Mod. 53-05 from the Ministry of Public Health (Ministerio de Salud Pública) for prescriptions

Use

prescription form

Context

Filled by Dr. Leopoldo Arús Gálvez on February 2, 1972, to attest a patient's medical condition (high blood pressure and mental health issues) to help him get his television set repaired.

Collection

The Cabrera Arús family collection

Acquisition

Source (if not Accessioned)

Leopoldo Arús Gálvez

Made/Created

Manufacturer

MINSAP

Date made

1972

Time Period

20th Century

Place

Country

Cuba

Region

Central America

Edition

Modelo 53-05

Inscription/Signature/Marks

Type

Inscription

Location

surface

Transcription

MOD. 52-05 MINSAP-DS-U. P. I. 200,000 K. MINISTERIO DE SALUD PUBLICA HOSPITALES Y POLICLINICOS UNIDAD: NOTA: SOLAMENTE SE PODRA FORMULAR UN MEDICAMENTO EN CADA RECETA FECHA MEDICO PACIENTE-NOMBRE HISTORIA CLINICA No. INGRESADO PENSIONISTA C. EXTERNA SALA CAMA 274 09-D2/23838

Language

Spanish

Translation

MOD. 52-05 MINSAP-DS-U. P. I. 200,000 K. MINISTRY OF PUBLIC HEALTH HOSPITALS AND POLYCLINICS UNIT: NOTE: ONLY ONE DRUG MAY BE FORMULATED ON EACH PRESCRIPTION. DATE PHYSICIAN PATIENT-NAME MEDICAL HISTORY No. ADMITTED PENSIONER EXTERNAL ROOM BED 274 09-D2/23838

Material/Technique

Ink

Type

Note

Location

surface

Transcription

Hago constar que Enrique Hernandez Herrera, de 64 años de edad, vecino de la calle Jovellar #5, entre Marina y Soledad, Apto. 11, tercer piso, en La Habana presenta hipertensión arterial marcada así como trastornos nerviosos, todo lo cual le impide salir a la calle, ir al cine, etc. motivo por el que necesita que le reparen el televisor roto. 29 de Febrero de 1972

Language

Spanish

Translation

I hereby state that Enrique Hernandez Herrera, of 64 years of age, resident of Jovellar Street #5, between Marina and Soledad, Apt. 11, third floor, in Havana, presents marked arterial hypertension as well as nervous disorders, all of which prevents him from going out in the street, to the movies, etc., which is why he needs to have his broken television set repaired. February 29, 1972

Material/Technique

Printed

Notes

typed

Parts

1

Material

Paper

Condition

Overall Condition

Good

Created By

María A. Cabrera Arús

Create Date

April 22, 2022

Updated By

María A. Cabrera Arús

Update Date

June 13, 2022