| Response | Yes | No |
| 1. Name of the drug | 1 | 2 |
| 2. Dose | 1 | 2 |
| 3. Indication | 1 | 2 |
| 4. Frequency | 1 | 2 |
| 5. Duration | 1 | 2 |
| 6. How to use (e.g. shaking) | 1 | 2 |
| 7. Storage at home | 1 | 2 |
| 8. Others |