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Date: 23.06.2014.

Name: Marko Marković DOB: 1st January 1970 Citizenship: Croatian Address: Ilica 1, 10000 Zagreb Country: Croatia Passport No.: 11111111

Diagnosis: - Crohn’s disease / Ulcerative Colitis -

Gastritis chr.

MEDICATION: -

mesalazine 3g/daily

-

methotrexate 15mg/weekly

-

infliximab 400mg every 2 months

-

Folic Acid 5mg/daily

_______________________ Name of doctor


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