<table class="MsoNormalTable" border="0" cellspacing="0" cellpadding="0" width="629" style="width: 471.85pt;">
 <tbody><tr style="mso-yfti-irow:0;mso-yfti-firstrow:yes;height:8.5pt">
  <td width="137" valign="top" style="width:102.55pt;border:solid windowtext 1.0pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:8.5pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;text-align:center;
  line-height:normal"><b><span style="font-size: 12pt; font-family: Arial, sans-serif;">Día y&nbsp;Fecha</span></b><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
  <td width="358" valign="top" style="width:268.45pt;border:solid windowtext 1.0pt;
  border-left:none;padding:0cm 5.4pt 0cm 5.4pt;height:8.5pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;text-align:center;
  line-height:normal"><b><span style="font-size: 12pt; font-family: Arial, sans-serif;">Fármaco</span></b><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
  <td width="134" valign="top" style="width:100.85pt;border:solid windowtext 1.0pt;
  border-left:none;padding:0cm 5.4pt 0cm 5.4pt;height:8.5pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;text-align:center;
  line-height:normal"><b><span style="font-size: 12pt; font-family: Arial, sans-serif;">Aplicación</span></b><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
 </tr>
 <tr style="mso-yfti-irow:1;height:11.4pt">
  <td width="137" valign="top" style="width:102.55pt;border:solid windowtext 1.0pt;
  border-top:none;padding:0cm 5.4pt 0cm 5.4pt;height:11.4pt">
  <p class="MsoNormal" style="margin-bottom:0cm;line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">&nbsp;</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
  <td width="358" style="width:268.45pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:11.4pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;text-align:center;
  line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">Hialuronato de sodio / Condroitin sulfato</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
  <td width="134" valign="top" style="width:100.85pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:11.4pt">
  <p class="MsoNormal" style="margin-bottom:0cm;line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">&nbsp;</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
 </tr>
 <tr style="mso-yfti-irow:2;height:10.05pt">
  <td width="137" valign="top" style="width:102.55pt;border:solid windowtext 1.0pt;
  border-top:none;padding:0cm 5.4pt 0cm 5.4pt;height:10.05pt">
  <p class="MsoNormal" style="margin-bottom:0cm;line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">&nbsp;</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
  <td width="358" style="width:268.45pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:10.05pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;text-align:center;
  line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">Condroitin sulfato</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
  <td width="134" valign="top" style="width:100.85pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:10.05pt">
  <p class="MsoNormal" style="margin-bottom:0cm;line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">&nbsp;</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
 </tr>
 <tr style="mso-yfti-irow:3;height:9.25pt">
  <td width="137" valign="top" style="width:102.55pt;border:solid windowtext 1.0pt;
  border-top:none;padding:0cm 5.4pt 0cm 5.4pt;height:9.25pt">
  <p class="MsoNormal" style="margin-bottom:0cm;line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">&nbsp;</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
  <td width="358" style="width:268.45pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:9.25pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;text-align:center;
  line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">Hialuronato de sodio / Condroitin sulfato</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
  <td width="134" valign="top" style="width:100.85pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:9.25pt">
  <p class="MsoNormal" style="margin-bottom:0cm;line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">&nbsp;</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
 </tr>
 <tr style="mso-yfti-irow:4;height:8.9pt">
  <td width="137" valign="top" style="width:102.55pt;border:solid windowtext 1.0pt;
  border-top:none;padding:0cm 5.4pt 0cm 5.4pt;height:8.9pt">
  <p class="MsoNormal" style="margin-bottom:0cm;line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">&nbsp;</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
  <td width="358" style="width:268.45pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:8.9pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;text-align:center;
  line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">Condroitin sulfato</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
  <td width="134" valign="top" style="width:100.85pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:8.9pt">
  <p class="MsoNormal" style="margin-bottom:0cm;line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">&nbsp;</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
 </tr>
 <tr style="mso-yfti-irow:5;height:9.5pt">
  <td width="137" valign="top" style="width:102.55pt;border:solid windowtext 1.0pt;
  border-top:none;padding:0cm 5.4pt 0cm 5.4pt;height:9.5pt">
  <p class="MsoNormal" style="margin-bottom:0cm;line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">&nbsp;</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
  <td width="358" style="width:268.45pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:9.5pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;text-align:center;
  line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">Hialuronato de sodio / Condroitin sulfato</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
  <td width="134" valign="top" style="width:100.85pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:9.5pt">
  <p class="MsoNormal" style="margin-bottom:0cm;line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">&nbsp;</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
 </tr>
 <tr style="mso-yfti-irow:6;height:17.1pt">
  <td width="137" valign="top" style="width:102.55pt;border:solid windowtext 1.0pt;
  border-top:none;padding:0cm 5.4pt 0cm 5.4pt;height:17.1pt">
  <p class="MsoNormal" style="margin-bottom:0cm;line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">&nbsp;</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
  <td width="358" style="width:268.45pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:17.1pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;text-align:center;
  line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">Condroitin sulfato</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
  <td width="134" valign="top" style="width:100.85pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:17.1pt">
  <p class="MsoNormal" style="margin-bottom:0cm;line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">&nbsp;</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
 </tr>
 <tr style="mso-yfti-irow:7;height:17.1pt">
  <td width="137" valign="top" style="width:102.55pt;border:solid windowtext 1.0pt;
  border-top:none;padding:0cm 5.4pt 0cm 5.4pt;height:17.1pt">
  <p class="MsoNormal" style="margin-bottom:0cm;line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">&nbsp;</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
  <td width="358" style="width:268.45pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:17.1pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;text-align:center;
  line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">Condroitin sulfato</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
  <td width="134" valign="top" style="width:100.85pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:17.1pt">
  <p class="MsoNormal" style="margin-bottom:0cm;line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">&nbsp;</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
 </tr>
 <tr style="mso-yfti-irow:8;mso-yfti-lastrow:yes;height:17.1pt">
  <td width="137" valign="top" style="width:102.55pt;border:solid windowtext 1.0pt;
  border-top:none;padding:0cm 5.4pt 0cm 5.4pt;height:17.1pt">
  <p class="MsoNormal" style="margin-bottom:0cm;line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">&nbsp;</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
  <td width="358" style="width:268.45pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:17.1pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;text-align:center;
  line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">Condroitin sulfato</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
  <td width="134" valign="top" style="width:100.85pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:17.1pt">
  <p class="MsoNormal" style="margin-bottom:0cm;line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">&nbsp;</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>
  </td>
 </tr>
</tbody></table>

<p class="MsoNormal" style="margin-bottom:0cm;line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">&nbsp;</span></p>

<p class="MsoNormal" style="margin-bottom:0cm;line-height:normal"><span style="font-size: 12pt; font-family: Arial, sans-serif;">Cantidades a
administrar:</span><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>

<p class="MsoNormal" style="margin-bottom:0cm;line-height:normal"><b><span style="font-size: 12pt; font-family: Arial, sans-serif;">CondroJet:&nbsp;&nbsp;<span style="background:yellow">&nbsp;&nbsp; &nbsp; &nbsp; &nbsp;&nbsp;ml</span></span></b><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>

<p class="MsoNormal" style="margin-bottom:0cm;line-height:normal"><b><span style="font-size: 12pt; font-family: Arial, sans-serif;">CartryJet:&nbsp;&nbsp;&nbsp;&nbsp;<span style="background:yellow">&nbsp; &nbsp; &nbsp; &nbsp;&nbsp;&nbsp;ml</span></span></b><span style="font-size: 12pt; font-family: Poppins;"><o:p></o:p></span></p>