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Sample Passport: What a patient sees when they scan the label.

Order ORD-60412. Every firm fictional.

A complete Evidence Passport for one order.

Built on the sample workspace: the lab's results beside the limits printed on the report, each ingredient traced to its own lot, the people behind the record, and a fingerprint anyone can recompute. It describes the paperwork, never the medicine.

Sample record: an Evidence Passport for order ORD-60412, batch CB-2026-1007-01. Sample data; every firm and person is fictional.

The pharmacy first. Then the medicine, its dates and who released it.

The pharmacy that dispensed it, then the preparation and the order, then plain facts a patient can read.

Dispensed by
Brennick Compounding
Preparation
Cyanocobalamin 1,000 mcg/mL
Batch and order
CB-2026-1007-01 · order ORD-60412
Beyond-use date
November 21, 2026, with a note to confirm with the pharmacy which date applies
Reviewed and released by
Dana Reyes, PharmD, on October 7, 2026
Strength
1,000 mcg/mL, as recorded in the certificate fields
Lab results
2 reported for the batch, and a sterility sample due October 21
Notices
None on record
Recall notices
“Be told if this batch is ever recalled.” An email address is all it asks for.

Each quick fact says what it does not settle.

The date line asks the patient to confirm with the pharmacy whether a date is an expiry, a retest date or the beyond-use date of the dispensed preparation, because a certificate's date and a label's date can differ for good reasons.

The sample Passport's questions page with everything on this record open: does this record match my order, issued by Brennick Compounding for order ORD-60412, the number on the label; is it still good to use, a beyond-use date of November 21, 2026, 38 days from today, with the sterility sample sent to Quellmark Analytical on 07 OCT 2026 and its result due 21 OCT 2026; and is anything wrong with it: no notice is recorded on this batch
The questions a patient asks, answered from the record: the order it belongs to, the beyond-use date and any notice on the batch.

Each result beside its printed limit.

The batch’s own results, each beside the limit printed on the same report, and whether one sits inside the other. Each ingredient’s results are listed under it, below.

TestResultLimit printed on the reportOn the Passport
Potency of the batch (HPLC)99.1% of labelled90.0 to 110.0% of labelledWithin the printed limit
SterilitySample sent October 7, result due October 21No growthNot reported yet
Bacterial endotoxinsLess than 0.5 EU/mLNMT 175 EU/mLWithin the printed limit

A result with no limit printed beside it reads not compared, rather than an invented limit. A sterility test takes 14 days, so its result is not reported yet, and the beyond-use date was set to hold without it: 45 days stored frozen, as the batch label prints, inside the USP <797> limit for a Category 2 preparation made from a nonsterile ingredient with no sterility test. If two certificate fields record different values for the same result, the line reads Values differ. Ask your pharmacy.

Under the results, the Passport lists the remaining certificate fields from a fixed allowlist of 13: strength, sample amount tested, assay or purity, sterility, bacterial endotoxin, pH, appearance, particulate matter, test method, testing laboratory, the date on the certificate, the date recorded as expiry, and the manufacturer.

Nothing outside the allowlist reaches a patient.

On this page each result is compared with the limit printed on its own report.

The pharmacy's review goes further, computing the endotoxin limit from the dose under USP <85> and checking the substance against FDA's records; that work stays in the workspace, and the Passport says only what paperwork was checked.

Every ingredient, with its own lot. And its own results.

For a compounded preparation, every ingredient with its lot, its supplier, whether a person reviewed it, and that ingredient's own lab results.

IngredientLot and supplierReviewed by a personFrom its certificate
Cyanocobalamin USPBM-5520 · Brookmere API Supply, made by Halden Fine ChemicalsYes, October 6, 2026Ingredient assay 99.1% (dried basis) against 96.0 to 102.0%
Sodium Chloride USPNC-3318 · Aurora Pharma SupplyYes, September 29, 2026Ingredient assay 99.8% (dried basis) against 99.0 to 100.5%

Behind the line for lot BM-5520 sits its history in the pharmacy's workspace. Its first certificate named the seller and not the maker, so the lot was held.

On October 6 a corrected certificate named Halden Fine Chemicals, a person reviewed the lot, and it cleared. A preparation made from a held ingredient lot is held with it, so no Passport issues on top of one.

Every hand, by role. With an honest caveat under them.

The roles the paperwork names, in order, with an honest caveat printed under them.

  1. Manufacturer: Halden Fine Chemicals

    Named on the corrected certificate and found in FDA's establishment registry as registered to manufacture, not only to relabel or repack.

  2. Supplier: Brookmere API Supply

    Sold lot BM-5520 and keeps a supplier file at the pharmacy, with every element dated.

  3. Compounded and released: Brennick Compounding

    Batch CB-2026-1007-01, released by Dana Reyes, PharmD on October 7, 2026, after a person's review of every ingredient lot.

  4. Received: Linden Row Clinic

    Received by shipment code on October 9, 2026. Shown where the clinic uses Custody, the shared record of who held each unit.

  5. Administered

    October 10, 2026, against the clinic's own reference. No patient name is recorded anywhere.

Under the list the Passport prints:

These are recorded roles, not proof of every physical handoff.Printed on every Passport, under its roles
Who handled it, and what was checked, on the sample Passport: sodium chloride made by Aurora Pharma Supply and cyanocobalamin made by Halden Fine Chemicals; received and checked by Brennick Compounding, the certificate read against the lot and reviewed by a person; released by Dana Reyes, PharmD on October 7, 2026; received by Linden Row Clinic on October 9 by shipment code; record issued and compounded by Brennick Compounding, beyond-use date November 21, 2026; these are the roles the records name, not proof of every physical handoff
Every hand by the role the records give it, with the caveat printed under them.

Check it yourself. The fingerprint is recomputed in your browser.

By recomputing its fingerprint in their own browser, from the fields on the screen.

The Passport carries a SHA-256 fingerprint of its visible fields. A button labelled Verify this yourself recomputes it locally and shows exactly what was hashed, in order.

Change any field and the fingerprint changes; a mismatch tells the reader not to rely on that copy and to open the live link instead.

The vial's Seal, the serialized QR on its label, carries a serial such as VS-7Q2K-8HMN, drawn from a 30-symbol alphabet with the look-alike characters removed, and a QR code to the same public page.

A recall a person declares appears on that page, attributed to whoever declared it, and a patient who saved the vial with an email address is told.

The sample Passport after verify this yourself: the fingerprint matches, recomputed in the browser from the fields listed, in the order they were hashed, with the recomputed SHA-256 beside the one on the record
The fingerprint recomputed in the patient's own browser, with the fields it was made from.

One record, two depths. The patient's view is narrower by design.

The same record at two depths. The patient's view is narrower by design.

In the pharmacy's workspaceOn the patient's Passport
The verdictOne of four headings, with every check and the standard behind itNo score, band or posture word
FindingsEach cited to its page and line, quoted word for wordNot shown. The record says what paperwork was checked
The certificateEvery value read, with the text as read beside the review13 allowlisted fields, each beside its printed limit
PeopleEvery reviewer, signature and reasonThe roles the paperwork names
Supplier notesInternal notes and correspondence with the supplierNever shown
The patientAn order reference that looks like patient text is refusedNo name, chart or prescription

The patient view tells the same nine steps from maker to patient in plain words. It says what paperwork was checked, and never that the medicine was tested.

Read this record as: the patient, the clinic or buyer, or the pharmacist and the inspector, chosen here; what the pharmacist and the inspector read, 9 entries, for order ORD-60416, ketoprofen 10% topical cream: lot KT-0716 received from Tessaline Supply, its certificate read with 5 values cited to their lines, the maker named on line 7, the assay of 99.6% inside its printed limit, the lot reviewed by Dana Reyes, PharmD, the batch compounded and reviewed, released, and the Passport issued on Oct 11
One record, read at three depths. The patient's view is the narrowest; the inspector's carries every entry.

Documentation only.

  • Documentation only. No product was tested and no supplier was approved.
  • Absence of a public-source match is not proof of absence.
  • A date on the record is documentary evidence. The pharmacy confirms which date applies to the dispensed preparation.
  • The order, batch, firms, lots and people on this page are sample data. They describe the shape of a record, not a shipment anyone received.
About this record, on the sample Passport: the Evidence Passport for batch CB-2026-1007-01 describes the paperwork, never the medicine; a summary of the recorded human decision; the certificate QMA-AS-1007 from Quellmark Analytical; the dated record of sign-off, creation and public release on October 7, 2026; the fingerprint 7b7816b92b5ad707; and what this is not: documentation evidence only
What the record is, and what it is not, printed on the Passport itself.

Issue Passports from your own lots.

One Evidence Passport per dispensed order, issued only from a lot a named person has reviewed, with a Seal on every unit. Scans and reprints are free.