| Thrombin |
| Exp________Date________ |
|
| Sterile Water |
| Exp________Date________ |
|
| Polymixin |
| Exp________Date________ |
|
| Papaverine |
| Exp________Date________ |
|
| Omnipaque |
| Exp________Date________ |
|
|
| Normal Saline |
| Exp________Date________ |
|
| Medication________________ |
| Strength______________ |
| Exp________Date________ |
|
| Medication________________ |
| Strength______________ |
| Exp________Date________ |
|
| Medication________________ |
| Strength______________ |
| Exp________Date________ |
|
| Iodine |
| Exp________Date________ |
|
|