Scribd Logo
Upload

Welcome to Scribd!

  • 8 views

    CHL or Diaz Epoxide

    Uploaded by

    titu61
    yghjiioh hh uh ho oho oih

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    CHL or Diaz Epoxide

    Uploaded by

    titu61
    8 views3 pages
    yghjiioh hh uh ho oho oih

    Original Title

    Chl or Diaz Epoxide

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    yghjiioh hh uh ho oho oih

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    8 views3 pages

    CHL or Diaz Epoxide

    Uploaded by

    titu61
    yghjiioh hh uh ho oho oih

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    You are on page 1of 3

    FORM - 5 Page 1 of 2

    QUARTERLY RETURN OF RECEIPT, IMPORT, SALE,


    CONSUMPTION OR EXPORT OF CONTROLLED
    SUBSTANCE
    (See clause 7)
    Return for the quarterly ending on 30-06-2023

    1. Name of the consumer : SURAKSHA PHARMA PVT. LTD.


    2. Address
    : FACTORY ADD. : KHASRA NO. 410, KARONDI VILLAGE ROORKEE-247667
    3. Name of the controlled substance
    : CHLORDIAZEPOXIDE IP
    4. Openig balance of the controlled substance
    : 5.087 KG
    at the beginning of the quarter

    5. Details of quantity received and sold, : AS PER GIVEN BELLOW


    consumed or exported

    Receipt
    Date Received from whom (Name and address of the person) Consignment Note No./Bill of entry No Quantity Received

    17-06- GLOBAL CALCIUM PRIVATE LIMITED 20232420458 DT. 12/06/23 1.000 KG


    2023 PLOT NO. 125 & 126, SIPCOT INDUSTRIAL COMPLEX, HOSUR
    17-06- ARIL PHARMACEUTICALS 2023-24/000922 DT. 1.000 KG
    2023 E-114 & 214,SAMBHAY COMPLEX,1ST FLR, REHNAI VILLAGE, BHIWANDI THANE 09/06/23

    Sale,consumption or export
    Date To whom sent (Name and address of the person.) Product Name Batch Size Bill No. Qty Qty Quality Mfg.
    Packing Batch No. Date Sent/ consumed Control Loss
    Pack
    Size

    11-04- MATERIAL DESPENSING FOR MFG. AMITRIPTYLINE HCL 200000TAB SRIS230172 12240 1.0200 100.00 6700.000
    2023 SURAKSHA PHARMA PVT LTD.. & CHLORDIAZEPOXID 29-04-2023
    BD104
    H.NO.15-31-1/HIG-V-101,1ST FLOOR 5TH PHASE,NEAR DMART AMSHA PLUS
    SPS20423
    KPHB COLONY KUKATPALLY HYDERABAD...-500072 1 strip 10Tabs

    RKE GODOWN RKE GODOWN 7080

    12-04- MATERIAL DESPENSING FOR MFG. AMITRIPTYLINE HCL 200000TAB SRIS230195 9840 1.0200 50.00 3450.000
    2023 GRACE DRUGS & PHARMACEUTICALS & CHLORDIAZEPOXID 04-05-2023
    BD112
    TOPTRIP C
    GRU60423
    1 strip 10Tabs
    AMSHA PLUS SRIS230184 9810
    SURAKSHA PHARMA PVT LTD.. 1 strip 10Tabs SPU70423 29-04-2023

    15-05- MATERIAL DESPENSING FOR MFG. AMITRIPTYLINE HCL 200000TAB SRIS230473 16320 1.0200 50.00 4650.000
    2023 SURAKSHA PHARMA PVT LTD.. & CHLORDIAZEPOXID 14-06-2023
    BE085
    H.NO.15-31-1/HIG-V-101,1ST FLOOR 5TH PHASE,NEAR AMSHA PLUS
    SPO70523
    DMART KPHB COLONY KUKATPALLY HYDERABAD...-500072 1 strip 10Tabs

    RKE GODOWN
    RKE GODOWN 3210

    16-05- MATERIAL DESPENSING FOR MFG. AMITRIPTYLINE & 198725TAB SRIS230473 15390 2.0270 100.00 3925.000
    2023 SURAKSHA PHARMA PVT LTD.. CHLORDIAZEPOXIDE 14-06-2023
    BE086
    H.NO.15-31-1/HIG-V-101,1ST FLOOR 5TH PHASE,NEAR AMSHA FORTE
    SPO80523
    DMART KPHB COLONY KUKATPALLY HYDERABAD...-500072 1 strip 10Tabs

    RKE GODOWN RKE GODOWN 4080

    17-06- SHELF QC TESTING 0.0100


    2023
    30-06- MATERIAL DESPENSING FOR MFG. AMITRIPTYLINE HCL 250000TAB SRIS230751 4950 1.2750 50.00 7850.000
    2023 DIACARDUS & CHLORDIAZEPOXID 03-08-2023
    BF145
    TRIJET PLUS DCAC70623
    1 strip 10Tabs

    SPAC80623 SRIS230772 15780


    SURAKSHA PHARMA PVT LTD.. 05-08-2023
    H.NO.15-31-1/HIG-V-101,1ST FLOOR 5TH PHASE,NEAR AMSHA PLUS
    DMART KPHB COLONY KUKATPALLY HYDERABAD...-500072
    1 strip 10Tabs
    RKE GODOWN RKE GODOWN 3480
    6. Closing balance the end of the quarter 0.715 KG
    Certified that the information given above is correct and the relevant records are available with me/us.
    Signature :
    Name :.
    Date : 30-06- Designation : AUTHORIZED
    2023 SIGNATORY FORM5

    You might also like