The template should also support the internal approval path and retention calculation. Schedule 4 requires the name, function, and signature of the person signing, plus the place and date of issue. That means the template should capture the issue date and any links needed for later retrieval by the manufacturer and importer.
A statement that cannot be version-controlled will eventually break the retention model, and if the product is on a Schedule 2A route the template should not be used as a substitute for checking those separate conditions.