Retailer’s Record For Narcotics and Psychotropic Medicines
Name of Drug in Generic Name: Name of Manufacturer:
Trade Name:
Date Batch No.
Mfg.Date&
Exp. Date
Qty.
Received
Supplier’s
Name
Patient’s Name Quantity
Dispensed
Prescribed
By
Name & Sig. of
Recipient
Dispenser’s
Name & Sig.
Qty. in
Stock
Remarks
Importer and Wholesale Record For Narcotics and Psychotropic Medicines
Name of Drug in Generic Name: Name of Manufacturer:
Trade Name:
Date Invoice
No.
Batch No.
Mfg. Date&
Exp. Date
Qty.
Received
Supplier’s
Name and
Address
Sold to Quantity Date Invoice No. Received
By
Qty. in
Stock
Remarks