Clinical Trials Medication Administration Record (MAR)
Patient Information
Patient Name
Patient ID
Date of Birth
Study ID
Site
Visit #
Date
Medication Details
Medication Name
Dosage
Route
Frequency
Lot/Batch #
Expiry Date
Preparation Date
Prepared by
Administration Record
Date/Time
Dose
Route
Administered By
Comments
Remarks
Reviewer Name
Reviewer Signature
Date