CAP. 134]

Form in which
sold or
supplied.

When sale is on a prescription, specify the ingredients of the
prescription.

Amount sold or supplied.

Date on which the transaction was effected.

Name of person,
body or firm to
whom sold or supplied.

Address of person, body or firm to whom sold or
supplied.

Authority of person, body or firm to be in possession of the drug.

44-

1
Dangerous Drugs.

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