The label provided for in section 26:10-9 of this title shall contain the items specified below and be in substantially the following form:

“Official Statement

Material used in filling

Made by

Address

Vendor (or successive vendors)

Address

This article is made in compliance with article 2 of chapter 10 of the title Health and Vital Statistics of the Revised Statutes (s. 26:10-6 et seq.).”