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GLP 1 MEDICATION ADMINISTRATION
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Starting Weight
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Last Week Weight
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Current Weight
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Current BMI
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Ordered Dose
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Dose Number
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Concentration of Vial
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NDC and Name of Pharmacy
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Dose Administered
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Number of Units Given
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Injection Site
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Lot Vial
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Administered by
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Expiration Date
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Time to Re-order
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