1. Preface: including the name of the medical institution, lidocaine prescription number, fee, patient name, gender, age, outpatient or inpatient medical record number, department or ward and bed number, clinical diagnosis, and issuance Date etc.

2. Text: Marked with RP or R, list the lidocaine drug name, specifications, quantity, usage and dosage.

3. Postscript: The doctor’s signature and special signature, the amount of lidocaine, and the signature of the pharmaceutical personnel who reviewed, prepared, checked, and distributed the medicine.