Application Form for the Grant/Renewal of a License to Manufacture for Sale of Ayurvedic or Unani Medicine 1. I/We _______________________________________________ of ___________________________________________ hereby apply for the grant/renewal of a license to manufacture Ayurvedic or Unani Drugs on the premises situated at ____________________________ . 2. Name of drugs to be manufactured (with Details) 3. Name qualifications and experience of technical staff employed for manufacture and Testing of Ayurvedic or Unani Drugs _________________________________ 4. A fee of Rupees ________________________ has been Credited to the Government under the head of account __________________________ and the relevant Treasury challan is enclosed here with. Date Signature of the applicant Office of the Chief Medical Officer, Jammu I here by declare that I receive the application From Mr/Miss/Mrs. _________________ bearing the Application No. ____________ Date : Signature of the Receiving Authority Place : Note :-The Copy of the Plan of the Premises will be attached along with this application form
