| Date: | 10/12/2025 | DEA Registrant: | TruCare Rx Pharmacy |
| DEA Registration #: | BT3102453 | DEA Registrant Address: | 102 Main Street, Anytown USA, 12345 |
| Schedule(s) Inventoried: |
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Time of Inventory: |
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| Inventory Performed by: | Inventory Witnessed by: |
| Annual Inventory of Controlled Substances | ||||||||||
| Line # | Drug Name / Strength / Dosage Form | Manufacturer | Schedule | Unopened Containers |
Opened Containers |
Total | ||||
| Qty | Container size |
Remaining Amount |
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| Drug Name / Strength / Dosage Form | |
| Manufacturer | |
| Schedule | |
| Unopened Containers: Quantity | |
| Unopened Containers: Package Size | |
| Open Containers: Remaining Amount | |
| Total Amount | |
