(a) the name of the detainee;
(b) the date and time when the test was carried out;
(c) the results of the test; and
(d) the name of the officer who carried out the test.
(2) A statement under subsection 23 (4) of the Act shall be accompanied—
(a) in the case of an alcohol test— by a copy of the form and print-out referred to in item 3.1 of Schedule 1; and
(b) in the case of a drug test—by a copy of the analyst's statement.