Schedule-3 (Relating to Sub-rule (2) of Rule 15 and Sub-rule (3) of Rule 16)

Schedule-3
(Relating to Sub-rule (2) of Rule 15 and Sub-rule (3) of Rule 16)

Report of the outcomes of the examination and analysis
It is certified that……….number of box kept the sample of drug……………send Mr./Mrs./Ms……………………………………enclosing the letter of ref
no……..dated………….., serial number…………….and indication no………for
examination and analysis is received. The condition of the box while
received and the outcomes of the examination and analysis of the drug are as
follows;
1. Condition of the seal set on the outside of the box and the pack:
2. Method adopted for the examination and analysis:
3. Outcomes of the examination and analysis:
4. Own opinion about the outcomes of the examination and analysis
Name of the research center or laboratory:
Stamp of the research center or laboratory:
Address of the research center or laboratory:
Analyst’s
Signature
Name and surname
Designation
Date

Note : The words Ministry of Forest in these Rules is, hereby, replaced by the
Ministry of Health from the year 2044 (1988) as per the decision of the
Government of Nepal.