SCHEDULE.
Record of
{
Here insert the name of the drug to which the record relates.
purchased or otherwise obtained.
Address of person, body or firm from whom obtained.
Amount
obtained.
Date on which supply
received.
Name of person, body or firm from whom obtained.
[reg. 10 (1).]
43
Form in which obtained.
Dangerous Drugs.
[CAP. 134
Record of
Here insert the name of the drug to which the record relates.
sold or supplied.