You would also need a section to record what camera you used. It'll help to troubleshoot problems should that happen in the future.
You'll definitely need some way to know which film this sheet of record ties to. Things like this has a tendency to get mixed up. It may be clear now but 10 years later, you may not be able to tell.
Are you sure you can keep this up? It's a lot of work to have this kind of record for every frame of every roll. I don't doubt this is great idea. I just don't know if this is practical.