The record required pursuant to Section 14328 shall include all of the following:
(a) A statement of the kind and quantity of the restricted drug sold.
(b) The date of sale.
(c) The name and address of the purchaser.
(d) The signature of the purchaser.
(e) Any other information as the director may determine is reasonably necessary to carry out the provisions of this chapter.
(Amended by Stats. 1976, Ch. 1224.)