ColicMix Ordering | Wilsons Pharmacy

03 332 3156

Wilsons Barrington Pharmacy

wilsonsdispensary@gmail.com

Dispensing Chemists Ph: (03) 332 3156 Fax (03) 332 8794

Barrington Pharmacy Ltd	Bevan Wilson
256 Barrington Street	Reg Pharm NZ
Christchurch 8024	M.P.S B.Pharm. B.Sc.

COLIC MIXTURE ORDER FORM

To order either the 100ml or 200ml Colic Mixture, please complete the below form and hit the Place Order Button.

To read more about our Colic Mix, please see our Baby Colic information page.

Babys First & Last Name

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Boy / Girl

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Date of Birth

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Has the child had Wilsons Colic Mix before?

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Baby weight

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Less than 6kg?

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Address

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Phone

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Email

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Please order me... COLIC MIXTURE 100ml - $13.99

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Please order me... COLIC MIXTURE 200ml - $24.99

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Preferred pick up date or time

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Address

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