Adverse Event or Product Complaint Intimation Form
Reference SOP No: CQA-041
 

Name: Country:
Contact Number: Email:
 

*Date of receipt of Complaint:
*Product Name and Stregth:
*Description Of Complaint:
Batch Number:
Manufacturing Month: Manufacturing year:
Expiry Month: Expiry Year:
*Complaint received from:-
Doctor: Patient: Retailer:
Warehouse: Stockist: Torrent Employee:
Other:
Contacts Details Of source of Complaint:-
Complaint Sample Received:
                                        Remarks:
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