Patient Medications Page oi' i Phone: 678-822-5810 Fax; 678-822-5811 Georgia Health Associates Michael Johnston BJ0111550 - Lic# 44500 - 1427116169 2191 Northlake Parkway Suite 22 Tucker, GA 30084 Patient: Hoder, Shawn. Date of Birth: Date: Oct 26,2011 oxYcopoNE Hoi. TABLETS, 30, MG, /Qs Sig: 1 tab Oral Every Eight Hours emergency Duration: 28 Days Quantity: 84 Dispense as Written? No. This Prescription may be filled using a Generic Drug Ren" 0 -I-'mes Qty' Remarks: eighty four* Provider Signature: Patient Medications page 1 of 3 Phone: 678-822-5810 Fax; 573.322-5311 Georgia Health Associates Michael Johnston BJ0111550 - Lic# 44500 - 1427116169 2191 Northlake Parkway Suite 22 Tugker, GA 30034 Patient: Hoder, Shawn I Dare 0fBir1h;- Address: Date: Oct 26,2011 ti LORTAB TABLETS, 1o;5oo, Sig: 1 tab Oral Every Six - Eight Hours pm emergency Duration: 28 Days Quantity: 84 Dispense as Written? No. This Prescription may be filled using a Generic Drug Ren" 0 1-'mes Qty' Remarks: eighty four' Provider Signature: Patient Medications Page oi' i Phone: 678-822-5810 Fax: 678-822-5811 Georgia Health Associates Michael Johnston BJ011155D - Lic# 44500 - 1427116169 2191 Nonhlake Parkway Suite 22 Tucker, GA 30084 Patient: Hoder, Shawn I Date of Birth: Date: Oct 26,2011 OXYCODONE HCL TABLETS, 30, MG, /'lee Sig: 1 tab Oral Every Eight Hours emergency Duration: 28 Days Quantity: 84 Dispense as Written? No. This Prescription may be filled using a Generic Drug Ren" 0 "mes I QW Remarks: eighty four Provider Signature: Patient Medications page 1 of 5