Selected Mercury Drug Outlets Local Pharmacies Biobita Probiotics Or, fill-out the order form below Thank you for your interest in Biobita. Please fill out the form as completely as possible so we can process your order. PATIENT'S INFORMATION Parent's Name Contact Number Email Address (required) Address Children's Name / Age (one name per line) PHYSICIAN'S INFORMATION Physician's Name Clinic Address Contact Number What will you be using Biobita for? (fill in options) Indication: Age of child 1 Daily SupplementDiarrheaConstipationAllergyPoor AppetiteOthers 2 Daily SupplementDiarrheaConstipationAllergyPoor AppetiteOthers 3 Daily SupplementDiarrheaConstipationAllergyPoor AppetiteOthers 4 Daily SupplementDiarrheaConstipationAllergyPoor AppetiteOthers 5 Daily SupplementDiarrheaConstipationAllergyPoor AppetiteOthers Other(s) Quantity to purchase x Biobita P350 = Delivery Charge Metro Manila: P 70Provinces: P 120 • VAT Inclusive • Scan Prescription • Delivery charge waived with ordering 5 bottles or more. Please attach a pdf or jpg of your doctor's prescription for Biobita.
